{"id":195,"date":"2012-04-19T02:49:38","date_gmt":"2012-04-18T17:49:38","guid":{"rendered":"\/sawamura\/wp\/?p=195"},"modified":"2024-01-09T09:53:14","modified_gmt":"2024-01-09T00:53:14","slug":"pnetembryonaltumor","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/pnetembryonaltumor\/","title":{"rendered":"\u80ce\u5150\u6027\u816b\u760d embryonal tumors"},"content":{"rendered":"<div class=\"setumei\">\n<ul>\n<li>\u5c0f\u5150\u306e\u8133\u306b\u767a\u751f\u3059\u308b\u60aa\u6027\u8133\u816b\u760d\u306e\u7dcf\u79f0\u3067\u3059<\/li>\n<li><span style=\"color: #ff0000;\"><strong>\u3059\u3079\u3066WHO \u30b0\u30ec\u30fc\u30c9\uff14\u3067\u3059<\/strong><\/span><\/li>\n<li>\u4f8b\u5916\u3082\u3042\u308a\uff0cCRINET\u306f\u826f\u6027\u816b\u760d\u306e\u3088\u3046\u306a\u3082\u306e\u3067\u3059<\/li>\n<li><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/medullo\/\"><strong><span style=\"color: #000080;\">\u9ac4\u82bd\u816b medulloblastoma <\/span><\/strong><\/a>\u3068\u00a0<a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/atrt\/\"><strong><span style=\"color: #000080;\">AT\/RT <\/span><\/strong><\/a>\u304c\u4ee3\u8868\u683c\u3067\u3059<\/li>\n<li>\u4ed6\u306e\u3082\u306e\u306f\u7121\u8996\u3057\u3066\u3044\u3044\u304f\u3089\u3044\u7a00\u3067\u3059<\/li>\n<li>2016\u5e74\u306b\u5206\u985e\u304c\u5909\u308f\u3063\u3066\uff0c<strong><span style=\"color: #ff0000;\">PNET \u30d4\u30fc\u30cd\u30c3\u30c8<span style=\"color: #000080;\"> \u3068\u3044\u3046\u75c5\u7406\u8a3a\u65ad\u540d\u304c\u7121\u304f\u306a\u308a\u307e\u3057\u305f\uff08\u6df7\u4e71!\uff09<\/span><\/span><\/strong><\/li>\n<li>2016\u307e\u3067\u306f\uff0c<span style=\"color: #000080;\"><strong>\u80ce\u5150\u6027\u816b\u760d\u306e\u5927\u90e8\u5206\u304cCNS-PNET\u3068\u3044\u3046\u75c5\u540d<\/strong><\/span>\u3067\u81e8\u5e8a\u7814\u7a76\u3055\u308c\u3066\u3044\u305f\u306e\u3067\uff0c\u533b\u5b66\u60c5\u5831\u306fPNET\u3068\u3057\u3066\u84c4\u7a4d\u3055\u308c\u3066\u3044\u307e\u3059\uff0c\u307e\u30602016\u5e74\u4ee5\u524d\u306e\u77e5\u8b58\u304c\u6368\u3066\u3089\u308c\u307e\u305b\u3093<\/li>\n<li>\u6cbb\u7642\u6cd5\u3092\u9078\u3076\u305f\u3081\u306e\u904e\u53bb\u306e\u6587\u732e\u306fPNET\u3092\u8aad\u307e\u306a\u3051\u308c\u3070\u51fa\u3066\u304d\u307e\u305b\u3093\u304b\u3089\uff0c2016\u5e74\u307e\u3067\u306e\u77e5\u8b58\u306f\u4e0b\u306e\u65b9\u306b\u66f8\u3044\u3066\u304a\u304d\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/braintumors\/pinealparenchymaltumor\/\">\u677e\u679c\u4f53\u82bd\u816b pineoblastoma<\/a><\/strong><\/span>\u306f\uff0c\u80ce\u5150\u6027\u816b\u760d\u3067\u3059\u304c\u677e\u679c\u4f53\u90e8\u816b\u760d\u306b\u5206\u985e\u3055\u308c\u307e\u3059<\/li>\n<\/ul>\n<hr \/>\n<h1>2021\u5e74WHO\u5206\u985e<\/h1>\n<p>\u9ac4\u82bd\u816b\u3068AT\/RT\u306f\u5225\u30da\u30fc\u30b8\u306b\u66f8\u3044\u3066\u3042\u308a\u307e\u3059\uff0c\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u8a73\u7d30\u306b\u98db\u3073\u307e\u3059<\/p>\n<\/div>\n<h5 align=\"left\"><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/medullo\/\">\u9ac4\u82bd\u816b<\/a><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/medullo\/\">\u00a0\u00a0Medulloblastoma (grade 4)<\/a><\/strong><\/span><\/h5>\n<p align=\"left\"><strong><span style=\"color: #000080;\">\u9ac4\u82bd\u816b\uff0c\u907a\u4f1d\u5b50\u7570\u5e38\u304c\u7279\u5b9a\u3055\u308c\u305f\u3082\u306e<br \/>\nMedulloblastomas, molecularly defined \u00a0 \u907a\u4f1d\u5b50\u8a3a\u65ad\u304c\u306a\u3055\u308c\u305f\u3082\u306e<br \/>\n<\/span><\/strong><span style=\"color: #000080;\"><strong>\u00a0 \u00a0Medulloblastoma, WNT activated<br \/>\n<\/strong><\/span>\u00a0 \u00a0 \u00a0 \u00a0WNT activated\u306f\u6cbb\u308a\u3084\u3059\u3044\u306e\u3067\u3059\u304c\uff0c\u30b0\u30ec\u30fc\u30c94\u3067\u3059<br \/>\n<strong><span style=\"color: #000080;\">\u00a0 \u00a0Medulloblastoma, SHH activated and\u00a0<em>TP53<\/em>\u00a0wildtype<br \/>\n<\/span><\/strong><strong><span style=\"color: #000080;\">\u00a0 \u00a0Medulloblastoma, SHH activated and\u00a0<em>TP53<\/em> mutant<br \/>\n<\/span><\/strong><em>\u00a0 \u00a0<\/em><span style=\"color: #000080;\"><strong>Medulloblastoma,\u00a0non-WNT\/non-SHH<\/strong><\/span><em><br \/>\n<\/em><\/p>\n<p align=\"left\"><strong><span style=\"color: #000080;\">\u9ac4\u82bd\u816b\uff0c\u7d44\u7e54\u8a3a\u65ad\u306e\u307f\u306b\u3088\u308b\u3082\u306e<br \/>\nMedulloblastoma histologicaly defined (grade 4)\u3000<\/span><\/strong><\/p>\n<h5 align=\"left\">\u9ac4\u82bd\u816b\u4ee5\u5916\u306e\u80ce\u5150\u6027\u816b\u760d other CNS embryonal tumors<\/h5>\n<p><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/atrt\/\">\u975e\u5b9a\u578b\u5947\u5f62\u816b\u69d8\uff0f\u30e9\u30d6\u30c9\u30a4\u30c9\u816b\u760d \u00a0<\/a><\/strong><strong><a style=\"color: #000080;\" title=\"AT\/RT\" href=\"\/sawamura\/pediattumor\/atrt\/\">AT\/RT<\/a><br \/>\nAtypical teratoid\/rhabdoid tumor \u00a0(grade 4)\u3000AT\/RT (\u30b0\u30ec\u30fc\u30c9 4)<\/strong><\/span><\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/atrt\/\"><span style=\"color: #000080;\"><strong><em>Cribriform neuroepithelial tumor CRINET<\/em><\/strong><\/span><\/a><\/p>\n<p><span style=\"color: #000080;\"><strong>\u591a\u5c64\u6027\u30ed\u30bc\u30c3\u30c8\u3092\u6709\u3059\u308b\u80ce\u5150\u6027\u816b\u760d<br \/>\nEmbryonal tumor with multilayered rosettes ETMR (\u30b0\u30ec\u30fc\u30c9 4)<\/strong><\/span><\/p>\n<p><strong><span style=\"color: #000080;\">\u4e2d\u67a2\u795e\u7d4c\u82bd\u816b <em>FOXR2<\/em>-activated<br \/>\n<\/span><\/strong><strong><span style=\"color: #000080;\">CNS Neuroblastoma, <em>FOXR2<\/em>-activated (\u30b0\u30ec\u30fc\u30c9 4)<\/span><\/strong><\/p>\n<p><strong><span style=\"color: #000080;\">CNS tumor with <em>BCOR<\/em> internal tandem duplication (\u30b0\u30ec\u30fc\u30c9 4)<\/span><\/strong><\/p>\n<p><strong><span style=\"color: #000080;\">CNS embryonal tumour (\u30b0\u30ec\u30fc\u30c9 4)<br \/>\n\u7279\u5b9a\u306e\u907a\u4f1d\u5b50\u7570\u5e38\u304c\u540c\u5b9a\u3067\u304d\u306a\u3044\u3082\u306e\uff0c\u304b\u3064\u3066\u306ePNET\u306e\u6982\u5ff5\u306b\u8fd1\u3044\u3082\u306e\u3067\u3059<br \/>\n<span style=\"color: #ff0000;\">\u5b9f\u306f\u3053\u308c\u304c\u4e00\u756a\u591a\u3044\uff01<\/span><\/span><\/strong><\/p>\n<p><b>\u305d\u306e\u4ed6\uff0c\u907a\u4f1d\u5b50\u8a3a\u65ad\u3055\u308c\u308b\u3082\u306e\u306b\uff0c<\/b><strong><span style=\"color: #000080;\">CNS Ewing sarcoma with a change in the <i>CIC<\/i> gene<\/span><\/strong><b>\uff0c<\/b><b><span style=\"color: #000080;\">CNS high-grade neuroepithelial tumor with a change in the <i>MN1<\/i> gene\u306a\u3069<\/span>\u304c\u3042\u308a\u307e\u3059<\/b><\/p>\n<h1><span style=\"color: #000080;\">\u4ee5\u4e0b\u306f\u5404\u8ad6\u3067\u3059\uff1a\u9ac4\u82bd\u816b\u3068AT\/RT\u306f\u5225\u30da\u30fc\u30b8\u306b\u66f8\u3044\u3066\u3042\u308a\u307e\u3059<\/span><\/h1>\n<hr \/>\n<h5><span style=\"color: #000080;\"><strong>\u591a\u5c64\u6027\u30ed\u30bc\u30c3\u30c8\u3092\u6709\u3059\u308b\u80ce\u5150\u6027\u816b\u760d<br \/>\nEmbryonal tumor with multilayered rosettes <span style=\"color: #ff0000;\">ETMR<\/span>\u00a0<\/strong><\/span><\/h5>\n<ul>\n<li><span style=\"color: #ff0000;\"><span style=\"color: #333333;\">\u3053\u308c\u3089\u306f\u53e4\u3044\u75c5\u540d\u3067\u3059\u304c\u540c\u7fa9\u306e\u3082\u306e\u3067\u3059\uff0c\u5168\u3066\u540c\u3058\u816b\u760d<\/span><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>ETANTR\u00a0embryonal tumor with abundant neuropil and true rosettes<\/strong><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>CNS PNET primitive neuroectodermal tumor\u306e\u4e00\u90e8<\/strong><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>ependymoblastoma \u00a0\u4e0a\u8863\u82bd\u816b<\/strong><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>medulloepithelioma \u00a0\u9ac4\u4e0a\u76ae\u7a2e<\/strong><\/span><\/li>\n<\/ul>\n<hr \/>\n<h4>\u5927\u307e\u304b\u306a\u3053\u3068<\/h4>\n<ul>\n<li>2000\u5e74\u306b\u306f\u3058\u3081\u3066\u8a18\u8f09\u3055\u308c\u307e\u3057\u305f<\/li>\n<li><span style=\"color: #ff0000;\"><strong>\u3059\u3054\u304f\u73cd\u3057\u3044\u4e73\u5e7c\u5150\u306b\u3067\u304d\u308b\u60aa\u6027\u8133\u816b\u760d<\/strong><\/span>\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u6c34\u982d\u75c7<\/strong><\/span>\u3067\u767a\u75c7\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li><span style=\"color: #ff0000;\"><strong>\u5e74\u9f62\u4e2d\u592e\u5024\u306f2\u6b73<\/strong><\/span>\u3067\uff0c\u307b\u3068\u3093\u3069\u304c4\u6b73\u672a\u6e80\u3067\u3059<\/li>\n<li>\u5927\u8133\uff0c\u8133\u5e79\u90e8\uff0c\u5c0f\u8133<span style=\"color: #ff0000;\"><strong>\u3069\u3053\u306b\u3067\u3082\u767a\u751f<\/strong><\/span>\u3057\u307e\u3059<\/li>\n<li>\u80ce\u5150\u6027\u8133\u816b\u760d\u306e\u4e2d\u3067\u3082\uff0c\u6cbb\u7642\u62b5\u6297\u6027\u3067<strong><span style=\"color: #ff0000;\">\u4e88\u5f8c\u304c\u6975\u3081\u3066\u60aa\u3044<\/span><\/strong>\u3082\u306e\u3067\u3059<\/li>\n<li><strong><a title=\"PNET \u30d4\u30fc\u30cd\u30c3\u30c8\" href=\"\/sawamura\/pediattumor\/pnet\/\">PNET<\/a><\/strong>\u3084<strong><a title=\"AT\/RT\" href=\"\/sawamura\/pediattumor\/atrt\/\">AT\/RT<\/a><\/strong>\u3068\u3068\u3066\u3082\u826f\u304f\u4f3c\u305f\u81e8\u5e8a\u50cf\u3092\u793a\u3057\u307e\u3059<\/li>\n<li><span style=\"color: #ff0000;\"><strong>\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f1\u5e74\u672a\u6e80<\/strong><\/span>\u306e\u5831\u544a\u304c\u591a\u3044\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>5\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f25%<\/strong><\/span>\u307b\u3069\u3067\u3059<\/li>\n<li>MRI\u4e0a\u3067\u306e\u7279\u5fb4\u306f\uff0c\u6d78\u6f64\u6027\u306e\u5897\u6b96\u3092\u793a\u3059\u3073\u307e\u3093\u6027\u80ce\u5150\u6027\u816b\u760d\u3068\u306f\u7570\u306a\u308a\uff0c ETMR\u306f<span style=\"color: #ff0000;\"><strong>\u584a\u3068\u306a\u3063\u3066\u5468\u56f2\u306e\u8133\u3092\u5727\u8feb\u3059\u308b\u3088\u3046\u306b\u5897\u5927<\/strong><\/span>\u3057\u307e\u3059\u00a0(Amamek D 2013)<\/li>\n<li>\u78ba\u7acb\u3055\u308c\u305f\u6cbb\u7642\u6cd5\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u3067\u3082\uff0c<span style=\"color: #ff0000;\"><strong>\u6cbb\u7642\u306f\u624b\u8853\u5f8c\u306b\u3059\u3050\u306b\u8a08\u753b\u3057\u3066\u958b\u59cb<\/strong><\/span>\u3057\u307e\u3059\uff0c\u5206\u5b50\u75c5\u7406\u78ba\u5b9a\u8a3a\u65ad\u3092\u5f85\u3063\u3066\u306f\u3044\u3051\u307e\u305b\u3093<\/li>\n<li>\u306a\u305c\u306a\u3089\uff12\u2212\uff13\u9031\u9593\u306e\u3046\u3061\u306b\u53d6\u308a\u8fd4\u3057\u304c\u3064\u304b\u306a\u3044\u304f\u3089\u3044\u9032\u884c\u3057\u3066\u3057\u307e\u3046\u304b\u3089\u3067\u3059<\/li>\n<li>25%\u307b\u3069\u3067\u9ac4\u6db2\u306b\u306e\u3063\u3066\u64ad\u7a2e\u8ee2\u79fb\u3057\u3066\u3044\u307e\u3059<\/li>\n<li>\u3067\u3082\uff0c\u4ed6\u306e\u80ce\u5150\u6027\u8133\u816b\u760d (\u9ac4\u82bd\u816b\uff0cAT\/RT) \u3088\u308a\u306f\u64ad\u7a2e\u6027\u683c\u306f\u4f4e\u3044\u3068\u3044\u3048\u307e\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\u5c40\u6240\u5236\u5fa1\u3092\u76ee\u7684\u3068\u3057\u305f\u6cbb\u7642\u9078\u629e\u304c\u306a\u3055\u308c\u307e\u3059<\/li>\n<li><strong><span style=\"color: #000080;\">\u521d\u767a\u6642\u304b\u3089\u64ad\u7a2e\u304c\u3042\u308b\u3068\u6cbb\u7642\u9069\u5fdc\u304c\u306a\u304f\u3066\uff0c\u7de9\u548c\u30b1\u30a2\u306e\u307f<\/span><\/strong>\u3092\u3057\u307e\u3059<\/li>\n<li>\u901a\u5e38\u5316\u5b66\u7642\u6cd5\u3067\u306f\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u304c\u3067\u304d\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #ff0000;\"><strong>\u6cbb\u7652\u53ef\u80fd\u3068\u8003\u3048\u3089\u308c\u308b\u6cbb\u7642 curative intent \u3092\u53d7\u3051\u3089\u308c\u305f\u5b50\u4f9b\u3067<\/strong><\/span>\uff0c<strong><span style=\"color: #ff0000;\">\u5168\u751f\u5b58\u671f\u9593\u306f\uff0c2\u5e74\u306729%\uff0c4\u5e74\u306727%\u3068\u3044\u3046\u591a\u6570\u4f8b\u5831\u544a\u304c\u3042\u308a\u307e\u3059<\/span><\/strong><\/li>\n<li>\u7cbe\u4e00\u676f\u306e\u6cbb\u7642\u304c\u3067\u304d\u3066\u30824\u4eba\u306e\u3046\u3061\u306e3\u4eba\u306f4\u5e74\u4ee5\u5185\u306b\u547d\u3092\u306a\u304f\u3057\u307e\u3059<\/li>\n<li>\u624b\u8853\u3067\u5168\u6458\u51fa\u3067\u304d\u3066\uff0c\u8853\u5f8c\u306b\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u53ef\u80fd\u3067\u3042\u3063\u305f\u5b50\u4f9b\u3067\u306e\u9577\u671f\u751f\u5b58\u306e\u5831\u544a\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>WHO\u57fa\u6e96\u306b\u5f93\u3063\u3066\uff0cC19MC\u5897\u5e45\u3092\u8abf\u3079\u308b\u306e\u306b1\u30f6\u6708\u3082\u6642\u9593\u3092\u304b\u3051\u3066\u3044\u308b\u3068\uff0c\u624b\u8853\u5f8c\u6b8b\u5b58\u816b\u760d\u306e\u6025\u6fc0\u306a\u5897\u5927\u306b\u906d\u9047\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<h4>\u753b\u50cf\u8a3a\u65ad<\/h4>\n<ul>\n<li>\u60aa\u6027\u795e\u7d4c\u81a0\u816b\u306e\u7279\u5fb4\u3092\u793a\u3059\u753b\u50cf\u6240\u898b\u3067\u3059<\/li>\n<li>\u816b\u760d\u5185\u51fa\u8840\uff0c\u591a\u623f\u6027\u306e\u3046\u80de\u3092\u307f\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u5468\u56f2\u8133\u6d6e\u816b\u304c\u5f37\u3044\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>MRIT1\u5f37\u8abf\u753b\u50cf\u3067\u4f4e\u4fe1\u53f7\uff0cT2\u3067\u9ad8\u4fe1\u53f7<\/li>\n<li>\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u3067\u90e8\u5206\u7684\u306b\u5897\u5f37\u3055\u308c\u307e\u3059\uff0c\u5168\u304f\u5897\u5f37\u3092\u307f\u306a\u3044\u3082\u306e\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u7d30\u80de\u5bc6\u5ea6\u304c\u9ad8\u3044\u306e\u3067CT\u3067\u9ad8\u5bc6\u5ea6\uff0cMRS\u3067choline\u304c\u9ad8\u304f\u306a\u308a\u307e\u3059<\/li>\n<li>\u9451\u5225\u5bfe\u8c61\u306f\uff0cAT\/RT\uff0c\u81a0\u82bd\u816b\uff0c\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\uff0c\u4ed6\u306e\u80ce\u5150\u6027\u816b\u760d\u3067\u3059\uff0c\u5f8c\u982d\u7aa9\u3067\u3042\u308c\u3070\u9ac4\u82bd\u816b\u3067\u3059<\/li>\n<\/ul>\n<h4>2021 WHO \u8a3a\u65ad\u57fa\u6e96<\/h4>\n<ul>\n<li>ETMR\u306f\uff0c<strong><span style=\"color: #ff0000;\">C19MC amplification<\/span><\/strong>\u304c\u3042\u308b\u3082\u306e\u3068\u5b9a\u7fa9\u3055\u308c\u307e\u3057\u305f<\/li>\n<li>ETMR\u3068\u7d44\u7e54\u8a3a\u65ad\u3060\u3051\u3067\u5224\u65ad\u3055\u308c\u308b\u3082\u306e\u306f\uff0c<span style=\"color: #000080;\"><em>embryonal tumor with multilayered rosettes, NOS\u00a0<\/em><span style=\"color: #000000;\">\u3068\u8a3a\u65ad\u3057\u3066\u8a18\u8f09\u3057\u6cbb\u7642\u3057\u307e\u3059<\/span><\/span><\/li>\n<li>\u75c5\u7406\u306f\u96e3\u3057\u3044\u306e\u3067\u82f1\u8a9e\u306e\u8a18\u8ff0\u3092\u501f\u308a\u308b\u3068\uff0cThis tumor has features of ependymoblastoma and neuroblastoma, demonstrating areas of fine fibrillary neuropil intermingled with ependymoblastic rosettes and zones of undifferentiated neuroepithelial cells<\/li>\n<li>\u4ed6\u306e\u80ce\u5150\u6027\u816b\u760d\u3068\u306e\u5927\u304d\u306a\u9451\u5225\u70b9\u306f\uff0c<span style=\"color: #000080;\"><strong>striking abundance of neuropil<\/strong><\/span>\u3067\u3059<\/li>\n<\/ul>\n<h4>\u6cbb\u7642<\/h4>\n<ul>\n<li>\u307e\u305a\uff0c\u624b\u8853\u5168\u6458\u51fa\u3067\u304d\u306a\u3044\u3068\u6551\u547d\u3067\u304d\u308b\u78ba\u7387\u306f\u3068\u3066\u3082\u4f4e\u304f\u306a\u308a\u307e\u3059<\/li>\n<li><span style=\"color: #ff0000;\"><strong>\u9032\u884c\u304c\u6975\u3081\u3066\u65e9\u3044\u816b\u760d\u306a\u306e\u3067\uff0c\u7d44\u7e54\u8a3a\u65ad\u3067\u8853\u5f8c\u6cbb\u7642\u3092\u958b\u59cb\u3057\u307e\u3059<\/strong><\/span><\/li>\n<li>\u5206\u5b50\u8a3a\u65ad\u3092\u5f85\u3061\u307e\u305b\u3093\uff0cETMR NOS\u3068\u3057\u3066\u6cbb\u7642\u958b\u59cb\u3092\u3057\u307e\u3059<\/li>\n<li>\u64ad\u7a2e\u3057\u3066\u3044\u308b\u3082\u306e\u3067\u306f\u6cbb\u7642\u9069\u5fdc\u3068\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u307e\u305a\u691c\u8a0e\u3057\u307e\u3059<\/li>\n<li>\u5927\u8133\u767a\u751f\u3067\u3042\u308c\u3070\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u7a4d\u6975\u7684\u306b\u8003\u616e\u3057\u307e\u3059<\/li>\n<li>\u305d\u306e\u5f8c\u306b\uff0calterations of the C19MC microRNA locus\u306e\u7d50\u679c\u3092\u898b\u3066\u78ba\u5b9a\u8a3a\u65ad\u3059\u308b\u3068\u3044\u3046\u306e\u304c\uff0c\u73fe\u6642\u70b9\u3067\u306f\u59a5\u5f53\u306a\u81e8\u5e8a\u7684\u5bfe\u5fdc\u3067\u3059<\/li>\n<\/ul>\n<h4><strong><span style=\"color: #000080;\">\u9ac4\u4e0a\u76ae\u7a2e <\/span>medulloepithelioma\u3068\u985e\u4e0a\u8863\u82bd\u816b ependymoblastoma<\/strong><\/h4>\n<ul>\n<li>ETMR\u306b\u6240\u5c5e\u3059\u308b\u80ce\u5150\u6027\u816b\u760d\u3067\u3059\u304c<em>C19MC<\/em>\u306e\u5909\u7570\u304c\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u80da\u795e\u7d4c\u7ba1\u306e\u795e\u7d4c\u4e0a\u76ae\u7d30\u80de\u306b\u985e\u4f3c\u3059\u308b\u672a\u5206\u5316\u7d30\u80de\u304c\u30b7\u30fc\u30c8\u72b6\uff0c\u7ba1\u72b6\uff0c\u7d22\u72b6\u306b\u914d\u5217\u3057\u307e\u3059<\/li>\n<li>\u7121\u8996\u3057\u3066\u3044\u3044\u307b\u3069\u7a00\u306a\u816b\u760d\u3067\u3059<\/li>\n<\/ul>\n<h5>\u6587\u732e<\/h5>\n<h4>ETMR\u306e\u5927\u898f\u6a21\u5171\u540c\u7814\u7a76<\/h4>\n<p class=\"heading-title\">Clinical phenotypes and prognostic features of embryonal tumours with multi-layered rosettes: a Rare Brain Tumor Registry study<br \/>\n159\u4f8b\u306e\u81e8\u5e8a\u7d4c\u904e\u5206\u6790\u3067\u3059\u3002\u5e74\u9f62\u4e2d\u592e\u5024\u306f26\u30f6\u6708 (18-36\u30f6\u6708\uff09\u3002\u4ed6\u306e\u80ce\u5150\u6027\u8133\u816b\u760d\u306b\u6bd4\u3079\u308c\u3070\u8ee2\u79fb\u306f\u5c11\u306a\u304f\uff0c128\u4f8b\u4e2d34\u4f8b (27%)\u306b\u751f\u3058\u3066\u3044\u307e\u3057\u305f\u3002154\u4f8b\u4e2d84\u4f8b (45%)\u304c\u5927\u8133\uff0c70\u4f8b\u306f\u4ed6\u306e\u90e8\u4f4d\u3067\u3057\u305f\u3002Hallmark C19MC alterations\u306f91\uff05\u306b\u307f\u3089\u308c\uff0c9%\u306fETMR NOS (not otherwise specific)\u3067\u3057\u305f\u3002<span style=\"color: #ff0000;\"><strong>\u6cbb\u7652\u53ef\u80fd\u3068\u8003\u3048\u3089\u308c\u308b\u6cbb\u7642 curative intent \u3092\u53d7\u3051\u3089\u308c\u305f\u5b50\u4f9b\u3067<\/strong><\/span>\uff0c6\u30f6\u6708\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f57%\uff0c2\u5e74\u5272\u5408\u306f31%\u3067\u3057\u305f\u3002<strong><span style=\"color: #ff0000;\">\u5168\u751f\u5b58\u671f\u9593\u306f\uff0c2\u5e74 29%\uff0c4\u5e74 27%<\/span><\/strong>\u3067\u3057\u305f\u3002\u751f\u5b58\u4f8b\u306b\u95a2\u9023\u3057\u305f\u8981\u7d20\u306f\uff0c\u8ee2\u79fb\u304c\u306a\u3044\uff0c\u8133\u5e79\u90e8\u4ee5\u5916\uff0c\u5168\u6458\u51fa\u4f8b\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u3057\u305f\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u306a\u3044\u901a\u5e38\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u305f\u4f8b\u3067\u306e2\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f0%\u3067\u3057\u305f\uff08\u305f\u3068\u3048\u5168\u6458\u51fa\u3067\u304d\u3066\u3044\u3066\u30820%\uff09\u3002\u4e00\u65b9\uff0c\u5168\u6458\u51fa\u3092\u53d7\u3051\u305f\u5f8c\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u305b\u305a\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u65bd\u884c\u4f8b\u3067\u306f21%\u3067\u3057\u305f\u3002\u5168\u6458\u51fa\u3092\u53d7\u3051\u3066\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u305f\u60a3\u5150\u306e2\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f66%\u3067\uff0c\u4e9c\u5168\u6458\u51fa\u306744%\u3067\u3057\u305f\u3002\u3053\u308c\u3089\u306emultinodal therapy\u306f patient-specific risk features\u306b\u5fdc\u3058\u3066\u6c7a\u3081\u3089\u308c\u308b\u3082\u306e tailored therapy \u3067\u3057\u305f\u3002<\/p>\n<div>\n<h4>ETANTR\u306e\u5256\u691c\u4f8b<\/h4>\n<p>Adamek D: Embryonal tumor with abundant neuropil and true rosettes: an autopsy case-based update and review of the literature. Childs Nerv Syst, 2013<br \/>\nMRI\u6240\u898b\u304cDIPG\u306b\u9177\u4f3c\u3057\u305f\u8133\u5e79\u90e8 ETMR\u306e\u75c7\u4f8b\u5831\u544a\u3067\u3059\u3002\u6d78\u6f64\u6027\u683c\u3092\u793a\u3055\u305a\uff0c\u584a expanding mass\u3068\u3057\u3066\u306e\u5897\u6b96\u304c\u7279\u5fb4\u3060\u3068\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4 align=\"left\"><strong><span style=\"color: #000080;\"><span style=\"color: #ff0000;\">LIN28A\u6297\u4f53<\/span>\u3067\u8a3a\u65ad\u304c\u3067\u304d\u308b<\/span><\/strong><\/h4>\n<p align=\"left\">Korshunov A, ey al.: LIN28A immunoreactivity is a potent diagnostic marker of embryonal tumor with multilayered rosettes (ETMR). Acta Neuropathol 124: 875-881, 2012<br \/>\nLIN28A\u304cETMR\u306e\u7279\u7570\u7684\u306a\u5206\u5b50\u30de\u30fc\u30ab\u30fc\u3067\u3042\u308b\u3068\u306e\u5831\u544a\u3067\u3059 (The encoded protein binds small RNA and has been implicated in stem cell pluripotency, metabolism and tumorigenesis. ) LIN28A\u7279\u7570\u6297\u4f53\u3067\u306e\u67d3\u8272\u3067\u306f\uff0cETMR37\u4f8b\u306e\u5168\u3066\u306e\u691c\u4f53\u3067\u5f37\u3044\u67d3\u8272\u6027\u304c\u5f97\u3089\u308c\u305f\uff0c\u4e00\u65b9\uff0c50\u4f8b\u306eAT\/RT\u3067\u306f6\u4f8b\u3067\u90e8\u5206\u7684\u306a\u67d3\u8272\u304c\u5f97\u3089\u308c\u305f\u306e\u307f\u3067\u3057\u305f\u3002800\u4f8b\u306e\u5c0f\u5150\u8133\u816b\u760d\u3067\u691c\u7d22\u3055\u308c\u307e\u3057\u305f\u304c\u4ed6\u306e\u816b\u760d\u578b\u3067\u306f\u967d\u6027\u4f8b\u304c\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n<h4><strong>\u9577\u671f\u751f\u5b58\u4f8b<\/strong><\/h4>\n<p>Manjila (2011) \u306f\u6cbb\u7642\u5f8c\uff17\u5e74\u306e\u751f\u5b58\u4f8b\u3092\u5831\u544a\u3057\u307e\u3057\u305f\u30024\u6b73\u306e\u6642\u306b\u767a\u75c7\u3057\u3066\uff0c\u53f3\u306e\u982d\u9802\u8449\u816b\u760d\u3067\u3042\u3063\u305f\u306e\u3067\u5e78\u3044\u306b\u3082\u624b\u8853\u3067\u5168\u6458\u51fa\u3067\u304d\u3066\u3044\u307e\u3059\u3002\u4e0a\u77e2\u72b6\u6d1e\u58c1\u306b\u6d78\u6f64\u304c\u3042\u3063\u305f\u3068\u306e\u8a18\u8f09\u304c\u3042\u308a\u307e\u3059\u3002\u8133\u810a\u9ac4\u7167\u5c04 (6 weeks, with 36 Gy) \u3068\u816b\u760d\u5e8a\u306b\u306f55.8 Gy\uff0c\u5316\u5b66\u7642\u6cd5\u306fChildren\u2019s Cancer Group Protocol 99701\u304c\u4f7f\u7528\u3055\u308c\u307e\u3057\u305f\u3002\u5177\u4f53\u7684\u306b\u306f\uff0cThe patient received carboplatin at the maximum tolerated dose (cumulative dose 1050 mg\/m<sup>2<\/sup>) and vincristine concurrently with radiation therapy. This was followed by cis-platinum (cumulative dose 450 mg\/m<sup>2<\/sup>), vincristine (cumulative dose 30 mg\/m<sup>2<\/sup>), and cyclophosphamide (cumulative dose 11.5 mg\/m<sup>2<\/sup>) over a period of 6 months (Arm B).<br \/>\n\u3053\u306e\u60a3\u5150\u304c\u9577\u671f\u751f\u5b58\u3067\u304d\u305f\u7406\u7531\u306f\uff0c\u624b\u8853\u3067\u816b\u760d\u304c\u5b8c\u5168\u6458\u3067\u304d\u305f\u3053\u3068\u3068\uff0cETMR\u3068\u3057\u3066\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3067\u304d\u308b\u5e74\u9577\u5150\u3067\u3042\u3063\u305f\u3053\u3068\u3068\u3067\u3059\u3002\u3053\u306e\u5316\u5b66\u7642\u6cd5\u306e\u6709\u52b9\u6027\u306e\u305f\u3081\u3067\u3042\u3063\u305f\u3068\u306f\u8003\u3048\u3065\u3089\u3044\u3067\u3059\u3002<\/p>\n<\/div>\n<hr \/>\n<h5><span style=\"color: #000080;\"><strong><span style=\"color: #ff0000;\">CRINET <\/span><\/strong><\/span><span style=\"color: #000080;\"><strong>cribriform neuroepithelial tumor<\/strong><\/span><\/h5>\n<ul>\n<li>\u5927\u304d\u304f\u3066\u5883\u754c\u660e\u77ad\uff0c\u306e\u3046\u80de\u5f62\u6210\u3092\u542b\u3080<span style=\"color: #000080;\"><strong>\u8133\u5ba4\u5185\u816b\u760d<\/strong><\/span>\u3068\u3057\u3066\u77e5\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>cribriform\u3068\u3044\u3046\u306e\u306f\u7be9\u72b6\u306e\u3001\u3075\u308b\u3044\u306e\u3088\u3046\u306a\u3068\u3044\u3046\u610f\u5473\u3067\u3059\uff0c<\/li>\n<li><span style=\"color: #000080;\"><strong>\u30e9\u30d6\u30c9\u30a4\u30c9\u306e\u7d44\u7e54\u50cf\u3092\u793a\u3055\u306a\u3044\u3051\u308c\u3069\u3082\uff0cINI1\u86cb\u767d\u6b20\u5931\uff08SMARCB1\u4e0d\u6d3b\u5316\uff09\u304c\u3042\u308b<\/strong><\/span>\u3082\u306e\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u4e73\u5150\u3068\u5e7c\u5150<\/strong><\/span>\u306e\u816b\u760d\u3067\u3059\u304c\uff0c\u6975\u3081\u3066\u7a00\u3067\u5c11\u6570\u306e\u5831\u544a\u3057\u304b\u3042\u308a\u307e\u305b\u3093\uff0c\u7537\u5150\u306b\u591a\u3044\u3067\u3059<\/li>\n<li>\u80ce\u5150\u6027\u816b\u760d\u306b\u5206\u985e\u3055\u308c\u308b\u306e\u3067\u3059\u304c\uff0cAT\/RT\u3068\u306f\u7570\u306a\u308a\u6bd4\u8f03\u7684\u4e88\u5f8c\u304c\u826f\u3044\u30b0\u30ec\u30fc\u30c92\u306b\u8fd1\u3044\u3082\u306e\u3068\u3057\u3066\u77e5\u3089\u308c\u307e\u3059<\/li>\n<li>\u4e73\u5e7c\u5150\u306e\u305f\u3081\u306b\u624b\u8853\u306f\u96e3\u3057\u3044\u306e\u3067\u3059\u304c\uff0c\u53ef\u80fd\u3067\u3042\u308c\u3070\u5168\u6458\u51fa\u3092\u3081\u3056\u3057\u307e\u3059<\/li>\n<li>\u6cbb\u7642\u306b\u53cd\u5fdc\u3057\u3066<span style=\"color: #000080;\"><strong>10\u5e74\u4ee5\u4e0a\u306e\u9577\u671f\u751f\u5b58\u3082\u671f\u5f85\u3067\u304d\u308b<\/strong><\/span>\u306e\u3067\uff0c\u521d\u671f\u6cbb\u7642\u306f\u3042\u307e\u308a\u4fb5\u8972\u306e\u5927\u304d\u3044\u3082\u306e\u306b\u3057\u306a\u3044\u3053\u3068\u304c\u809d\u8981\u3067\u3059<\/li>\n<li>AT\/RT\u306evariant\u3068\u3082\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u75c5\u7406\u3067\u306f\uff0c\u67f5\u72b6\u3001\u7d22\u72b6\u3001\u7be9\u72b6\u306e\u4e0a\u76ae\u69d8\u914d\u5217\u3092\u793a\u3057 (cribriform strands, trabeculae) EMA positive\u3067\u3059<\/li>\n<\/ul>\n<hr \/>\n<div class=\"page\" title=\"Page 6\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<h5><span style=\"color: #ff0000;\"><strong>CNS NB-FOXR2<\/strong><\/span>\u00a0<strong style=\"background-color: #f4f9ff;\"><span style=\"color: #000080;\">\u00a0FOXR2\u6d3b\u6027\u5316\u304c\u3042\u308b<\/span><\/strong><strong style=\"background-color: #f4f9ff;\"><span style=\"color: #000080;\">\u4e2d\u67a2\u795e\u7d4c\u82bd\u816b<\/span><\/strong><\/h5>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<ul>\n<li>\u8133\u306e\u3069\u3053\u306b\u3067\u3082\u767a\u751f\u3057\u307e\u3059\u304c\uff0c<span style=\"color: #000080;\"><strong>\u9ac4\u819c\u767a\u751f<\/strong><\/span>\u306e\u5831\u544a\u3082\u5c11\u306a\u304f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u8133\u306e\u80ce\u5150\u6027\u816b\u760d\u306e10%\u307b\u3069\u304c\uff0cROXR2\u907a\u4f1d\u5b50\u306b\u5909\u7570\u306e\u3042\u308bCNS neuroblastoma\u3067\u3059<\/li>\n<li>forkhead box R2 (<em>FOXR2<\/em>) \u907a\u4f1d\u5b50\u306e\u904e\u5270\u767a\u73fe\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u304b\u3064\u3066\u306f\uff0cCNS-PNET\u3042\u308b\u3044\u306f\u5358\u306b\u8133\u306e\u795e\u7d4c\u82bd\u816b neuroblastoma\u3068\u547c\u3070\u308c\u307e\u3057\u305f<\/li>\n<li>\u75c5\u7406\u7d44\u7e54\u50cf\u306f\uff0c\u5c0f\u3055\u306a\u5186\u5f62\u6838\u306e\u7d30\u80de small round cell tumor\uff0c\u7d30\u80de\u5bc6\u5ea6\u304c\u9ad8\u304f\uff0c\u6838\u5206\u88c2\u50cf\u304c\u591a\u6570\u307f\u3068\u3081\u3089\u308c\u308b\u60aa\u6027\u816b\u760d\u3068\u6349\u3048\u3089\u308c\u307e\u3059<\/li>\n<li>\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u304c\u6709\u52b9\u3067\u6cbb\u7642\u53cd\u5fdc\u6027\u304c\u826f\u3044\u80ce\u5150\u6027\u816b\u760d\u3067\u3059<\/li>\n<li>\u8133\u810a\u9ac4\u7167\u5c04\u3068\u5c40\u6240\u7167\u5c04\u3092\u884c\u3044\u5316\u5b66\u7642\u6cd5\u3092\u52a0\u3048\u308b\u306e\u304c\u6a19\u6e96\u7684\u306a\u6cbb\u7642\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>5\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f80%\u4ee5\u4e0a<\/strong><\/span>\u306b\u306a\u308b\u306e\u3067\uff0c\u6cbb\u7642\u3092\u52a0\u3048\u308b\u6642\u306b\u306f\u6669\u671f\u969c\u5bb3\u3082\u8003\u616e\u306b\u5165\u308c\u3066\u6551\u547d\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u6a19\u6e96\u30ea\u30b9\u30af\u7fa4\u306b\u7528\u3044\u3089\u308c\u308b\u8133\u810a\u9ac4\u7167\u5c04\u306f\u8efd\u6e1b\u3055\u308c\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<\/ul>\n<hr \/>\n<h5><span style=\"color: #000080;\"><strong><span style=\"color: #ff0000;\">\u4e2d\u67a2\u795e\u7d4c \u795e\u7d4c\u7bc0\u82bd\u7d30\u80de\u816b<\/span>\u00a0<\/strong><\/span><span style=\"color: #000080;\"><strong>CNS ganglioneuroblastoma\u00a0<\/strong><\/span><\/h5>\n<ul>\n<li>ganglioneuroblastoma\u306f\u526f\u814e\u306e\u816b\u760d\u3067\u3059<\/li>\n<li>\u307e\u308c\u306b\u8133\u306b\u3082\u767a\u751f\u3057\u307e\u3059\u304c\uff0c\u75c7\u4f8b\u5831\u544a\u3082\u307b\u3068\u3093\u3069\u306a\u3044\u3068\u3044\u3046\u3088\u3046\u306a\u983b\u5ea6\u3067\u3059<\/li>\n<li>5\u6b73\u4ee5\u4e0b\u306b\u767a\u751f\u3059\u308b\u30b0\u30ec\u30fc\u30c94\u306e\u60aa\u6027\u816b\u760d\u3067\u3059<\/li>\n<li>MIBG (metaiodobenzylguanidine) scan\u3067\uff0c\u5168\u8eab\u8ee2\u79fb\u3092\u8abf\u3079\u307e\u3059<\/li>\n<li>\u6cbb\u7642\u65b9\u6cd5\u306f\u78ba\u7acb\u3055\u308c\u3066\u3044\u307e\u305b\u3093<\/li>\n<li>\u53ef\u80fd\u3067\u3042\u308c\u3070\u624b\u8853\u3067\u5168\u6458\u51fa\u3057\u3066\uff0c\u8853\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u5fc5\u8981\u3068\u306a\u308a\u307e\u3059<\/li>\n<li>\u5316\u5b66\u7642\u6cd5\u306f\u306e\u6709\u52b9\u6027\u306f\u4f4e\u3044\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u672a\u5206\u5316\u306a\u795e\u7d4c\u5916\u80da\u8449\u7d30\u80de\uff08\u80ce\u5150\u6027\u816b\u760d\u7d30\u80de embryonal cells\uff09\u3067\u69cb\u6210\u3055\u308c\u307e\u3059<\/li>\n<li>\u795e\u7d4c\u7d30\u80de neurocytes \u3042\u308b\u3044\u306f\u795e\u7d4c\u7bc0\u7d30\u80de ganglion cells \u3092\u542b\u3080\u306e\u304c\u7279\u9577\u3067\u3059<\/li>\n<li>dystrophic ganglion cells\u304c\u512a\u4f4d\u306a\u4e2d\u3067\u3082\uff0c\u672a\u5206\u5316\u306a\u795e\u7d4c\u82bd\u7d30\u80de\u306b\u306f\u6838\u5206\u88c2\u50cf\u3068apoptotic bodis \u304c\u76ee\u7acb\u3061\u307e\u3059<\/li>\n<li>\u795e\u7d4c\u7d30\u80de\u3078\u306e\u5206\u5316\u5ea6\u306f\u3055\u307e\u3056\u307e\u30672\u6838\u306e\u795e\u7d4c\u7bc0\u7d30\u80de\u306e\u96c6\u7c07\u304c\u7279\u5fb4\u3067\u3042\u308a\uff0cHormer Wright rosettes, palsading pattern, \u9846\u7c92\u72b6\u77f3\u7070\u5316\u3092\u4f34\u3046\u58ca\u6b7b\u50cf\u304c\u307f\u3089\u308c\u307e\u3059<\/li>\n<li>MIB-1\u67d3\u8272\u306f\u672a\u5206\u5316\u7d30\u80de\u306e\u90e8\u5206\u306b\u9ad8\u304f\uff0c\u795e\u7d4c\u5206\u5316\u304c\u3042\u308b\u90e8\u5206\u306b\u306f\u758e\u3068\u306a\u308a\u307e\u3059<\/li>\n<\/ul>\n<hr \/>\n<h5 class=\"heading-title\">BOCR\u907a\u4f1d\u5b50\u5185\u7e26\u5217\u91cd\u8907\u3092\u4f34\u3046\u9ad8\u60aa\u6027\u5ea6\u4e2d\u67a2\u795e\u7d4c\u4e0a\u76ae\u6027\u816b\u760d<br \/>\nCNS High-grade neuroepithelial tumor with BCOR internal tandem duplication<br \/>\nCNS HGNET-BCOR ex15 ITD<\/h5>\n<ul>\n<li>\u5c0f\u3055\u306a\u5b50\u4f9b\u306e\u5927\u8133\u534a\u7403\u3068\u5c0f\u8133\u534a\u7403\u306b\u767a\u751f\u3059\u308b\u816b\u760d\u3067\u3059<\/li>\n<li>\u304b\u3064\u3066PNET\u3068\u547c\u3070\u308c\u3066\u3044\u305f\u816b\u760d\u306b\u5c5e\u3057\u3066\u3044\u307e\u3059<\/li>\n<li>\u8089\u816b sarcoma\u3042\u308b\u3044\u306f\u9593\u8449\u7cfb\u816b\u760d mesenchymal tumor \u3068\u3044\u3046\u6027\u8cea\u3092\u6709\u3059\u308b\u60aa\u6027\u8133\u816b\u760d\u3067\u3059<\/li>\n<li>\u767a\u75c7\u6642\u306b\uff0c\u5883\u754c\u304c\u660e\u77ad\u306a\u3068\u3066\u3082\u5927\u304d\u306a\u816b\u760d\u3068\u3057\u3066\u767a\u898b\u3055\u308c\u307e\u3059<\/li>\n<li>MRI\u3067\u5185\u90e8\u306f\u307e\u3060\u3089\u3067\uff0c\u6591\u304c\u3042\u308b\u3088\u3046\u306b\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\uff0c\u62e1\u6563\u5f37\u8abf\u753b\u50cf\u3067\u4f4e\u4fe1\u53f7\u306e\u90e8\u5206\u3092\u542b\u307f\u307e\u3059<\/li>\n<li>\u75c5\u7406\u7d44\u7e54\u3067\u306f\uff0c\u306e\u3046\u80de\u304c\u5c11\u306a\u304f\uff0c\u795e\u7d4c\u81a0\u816b\u306e\u3088\u3046\u306b\u7e4a\u7dad\u6027\u3067\uff0c\u8840\u7ba1\u5468\u56f2\u507d\u30ed\u30bc\u30c3\u30c8\u5f62\u6210 perivascular pseudorosettes\u304c\u3042\u308a\uff0c\u58ca\u6b7b palisading necrosis \u304c\u6df7\u5728\u3057\u307e\u3059\u3002\u5fae\u5c0f\u8840\u7ba1\u5897\u751f\u304c\u306a\u304f\uff0cGFAP, synaptophysin\u304c\u9670\u6027\u3067\uff0c<span style=\"color: #000080;\"><strong>Olig2\u3068NeuN\u306f\u3068\u304d\u306b\u5f37\u3044\u69d8\u3005\u306a\u67d3\u8272\u6027<\/strong><\/span>\u3092\u793a\u3057\uff0c<span style=\"color: #000080;\"><strong>\u6838\u306b\u5f37\u3044BCOR\u967d\u6027\u3092\u8a8d\u3081\u307e\u3059<\/strong><\/span>\u3002<\/li>\n<li>\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u306b\u4f3c\u3066\u3044\u308b\u5149\u9855\u6240\u898b\u3067\u3042\u308b\u3068\u8a00\u3048\u307e\u3059<\/li>\n<li>\u8133\u810a\u9ac4\u7167\u5c04\u304c\u7528\u3044\u3089\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u304c\uff0c\u5c0f\u3055\u3044\u5b50\u4f9b\u306a\u306e\u3067\u653e\u5c04\u7dda\u969c\u5bb3\u304c\u907f\u3051\u3089\u308c\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #000080;\"><strong>\u814e\u81d3\u306eclear cell sarcoma<\/strong><\/span>\u3084\u8edf\u90e8\u7d44\u7e54\u306eundifferentiated round cell sarcoma\u3068\u540c\u3058\u30bf\u30a4\u30d7\u306e\u816b\u760d\u3067\u3059\u304b\u3089\uff0c\u5316\u5b66\u7642\u6cd5\u306f\u305d\u308c\u306b\u6e96\u3058\u3066\u5229\u7528\u3055\u308c\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u6cbb\u7642\u62b5\u6297\u6027\u3067\u4e88\u5f8c\u306f\u6975\u3081\u3066\u60aa\u3044\u306e\u3067\u3059\u304c\uff0c\u9577\u671f\u751f\u5b58\u4f8b\u306e\u5831\u544a\u3082\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<h5>\u6587\u732e<\/h5>\n<div class=\"page\" title=\"Page 1\">\n<div class=\"section\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<h4>CNS NB-<em>FOXR2<\/em>\u306e\u4e88\u5f8c\u306f\u826f\u3044<\/h4>\n<p>von Hoff K: Therapeutic implications of improved molecular diagnostics for rare CNS-embryonal tumor entities: results of an international, retrospective study. Neuro Oncol 2021<br \/>\n\u7570\u306a\u3063\u305f\u6bcd\u96c6\u56e3\u306a\u306e\u3067\u3059\u304c\uff0cPNET\u3068\u8a3a\u65ad\u3055\u308c\u305f302\u4f8b\u3068CNS NB-FOXR2\u3068\u8a3a\u65ad\u3055\u308c\u305f66\u4f8b\uff0c\u8a08368\u4f8b\u306e\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u30d7\u30ed\u30d5\u30a1\u30a4\u30eb\u304c\u89e3\u6790\u3055\u308c\u307e\u3057\u305f\u3002PNET\u3068\u3055\u308c\u305f\u3082\u306e\u3067CNS NB-FOXR2\u3067\u3042\u3063\u305f\u3082\u306e\u306f36\u4f8b(12%)\u3067\u3057\u305f\u3002CNS NB-FOXR2\u306e5\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f63%\uff0c\u5168\u751f\u5b58\u5272\u5408\u306f85\uff05\u3067\u3057\u305f\u3002\u8133\u810a\u9ac4\u7167\u5c04\u3068\u5c40\u6240\u7167\u5c04\u3068\u5316\u5b66\u7642\u6cd5\u304c\u52a0\u3048\u3089\u308c\u305f\u4f8b\u3067\u306f42\u4f8b\u4e2d\u306e35\u4f8b\u304c\u518d\u767a\u7121\u3057\u306b\u751f\u5b58\u3057\u3066\u3044\u307e\u3057\u305f\u3002\u9577\u671f\u751f\u5b58\u304c\u671f\u5f85\u3067\u304d\u308b\u80ce\u5150\u6027\u816b\u760d\u306a\u306e\u3067\uff0c\u6669\u671f\u969c\u5bb3\u3092\u8003\u616e\u306b\u5165\u308c\u305f\u521d\u671f\u6cbb\u7642\u306e\u8efd\u6e1b\u304c\u5fc5\u8981\u3060\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-22129\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/solaillust2-1-450x600.jpg\" alt=\"\" width=\"450\" height=\"600\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/solaillust2-1-450x600.jpg 450w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/solaillust2-1-225x300.jpg 225w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/solaillust2-1-768x1024.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/solaillust2-1.jpg 1108w\" sizes=\"auto, (max-width: 450px) 100vw, 450px\" \/><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"setumei\">\n<hr \/>\n<h1><span style=\"color: #000080;\">\u3053\u3053\u304b\u3089\u4e0b\u306f\u904e\u53bb\u306ePNET\u306e<\/span><span style=\"color: #000080;\">\u53e4\u3044\u77e5\u8b58\u3067\u3059\u304b\u3089\uff0c\u5fc5\u8981\u3042\u308a\u307e\u305b\u3093<\/span><\/h1>\n<h1><span style=\"color: #000080;\">CNS PNET (primitive neuroectodermal tumor)<br \/>\n2015\u5e74\u4ee5\u524d\u306e\u3082\u306e\u3067\u3059\u304c\u6368\u3066\u3089\u308c\u306a\u3044\u77e5\u8b58<\/span><\/h1>\n<ul>\n<li>2015\u5e74\u4ee5\u524d\u306b\u306f\uff0c\u539f\u59cb\u795e\u7d4c\u5916\u80da\u8449\u816b\u760d\u00a0(primitive neuroectodermal tumor)\u306f\uff0cPNET\uff08<span style=\"color: #000000;\"><span style=\"color: #ff0000;\"><strong>\u30d4\u30fc\u30cd\u30c3\u30c8<\/strong><\/span>\uff09<\/span>\u3068\u547c\u3070\u308c\u308b\u8a3a\u65ad\u540d\u304c\u3042\u308a\u307e\u3057\u305f<\/li>\n<li>\u9ac4\u82bd\u816b\u304c\u30c6\u30f3\u30c8\u306e\u4e0b\u306e\u5c0f\u8133\u304b\u3089\u767a\u751f\u3059\u308b\u306e\u306b\u5bfe\u3057\u3066\uff0cPNET\u306f\u30c6\u30f3\u30c8\u306e\u4e0a\u306e<span style=\"color: #000000;\">\u5927\u8133\u304b\u3089\u767a\u751f\u3059\u308b\u304b\u3089<\/span><span style=\"color: #000080;\"><strong>\u30c6\u30f3\u30c8\u4e0aPNET<\/strong><\/span>\u3068\u547c\u3070\u308c\u305f\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u9ac4\u82bd\u816b\u3088\u308a\u3055\u3089\u306b<strong><span style=\"color: #ff0000;\">\u60aa\u6027\u5ea6\u306f\u9ad8\u3044<\/span><\/strong>\u3067\u3059<\/li>\n<li>\u80ce\u5150\u671f\u306b\u8133\u3092\u4f5c\u308b\u7d30\u80de\u306e\u3082\u3068\u306b\u306a\u3063\u3066\u3044\u308b\u7d30\u80de\u304b\u3089\u767a\u751f\u3059\u308b\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u3068\u3066\u3082<span style=\"color: #000080;\"><strong>\u5c0f\u3055\u3044\u5b50\u4f9b\uff08\uff15\u6b73\u4ee5\u4e0b\uff09\u306e\u5927\u8133<\/strong><\/span>\u304b\u3089\u767a\u751f\u3059\u308b\u816b\u760d\u3067\u3059<\/li>\n<li>\u982d\u84cb\u5185\u5727\u4ea2\u9032\u75c7\u72b6\u3068\u3044\u3046\u982d\u75db\u3084\u5614\u5410\uff0c\u610f\u8b58\u969c\u5bb3\uff08\u53cd\u5fdc\u304c\u306b\u3076\u3044\uff09\u3067\u767a\u75c7\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u767a\u75c7\u3057\u305f\u6642\u306b\u306f\u3059\u3067\u306b<span style=\"color: #000080;\"><strong>\u5de8\u5927\u306a\u816b\u760d<\/strong><\/span>\u306b\u306a\u3063\u3066\u3044\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u9ac4\u6db2\u306b\u306e\u3063\u3066<strong><span style=\"color: #ff0000;\">\u8133\u306e\u4ed6\u306e\u90e8\u5206\u3084\u810a\u9ac4\u306b\u8ee2\u79fb\uff08\u9ac4\u6db2\u64ad\u7a2e\uff09\u3059\u308b<\/span><\/strong>\u3068\u52a9\u304b\u308b\u671b\u307f\u306f\u5c11\u306a\u3044\u3067\u3059<\/li>\n<li>\u8a3a\u65ad\u306fMRI\u3067\u3057\u307e\u3059\u304c\uff0c\u6700\u521d\u304b\u3089<span style=\"color: #000080;\"><strong>\u5fc5\u305a\u810a\u9ac4\u306e\u65b9\u3082\u8abf\u3079\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/strong><\/span><\/li>\n<\/ul>\n<h5>2018\u5e74\u6642\u70b9\u3067\u306e\u6349\u3048\u65b9<\/h5>\n<p>Hwang EI, et al.: Extensive Molecular and Clinical Heterogeneity in Patients With Histologically Diagnosed CNS-PNET Treated as a Single Entity: A Report From the Children&#8217;s Oncology Group Randomized ACNS0332 Trial.\u00a0<span role=\"menubar\">J Clin Oncol.<\/span> 2018<br \/>\n\u904e\u53bb\u306bPNET\u3068\u3057\u3066\u81e8\u5e8a\u8a66\u9a13\u3055\u308c\u305f\u4f8b\u3092\u5206\u5b50\u8a3a\u65ad\u3057\u3066\u307f\u308b\u3068\uff0c<span style=\"color: #000080;\"><strong>\u80ce\u5150\u6027\u816b\u760d\uff0f\u677e\u679c\u4f53\u82bd\u816b\u3068\u8a3a\u65ad\u3067\u304d\u308b\u3082\u306e\u306e5\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f78%<\/strong><\/span>\uff0c<strong><span style=\"color: #000080;\">\u9ad8\u60aa\u6027\u5ea6\u30b0\u30ea\u30aa\u30fc\u30de high-grade glioma\u3068\u5206\u5b50\u8a3a\u65ad\u3067\u304d\u308b\u3082\u306e\u3067\u306f12%<\/span><\/strong>\u3067\u3042\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n<p>PNET\u3068\u3044\u3046\u7d44\u7e54\u8a3a\u65ad\u7fa4\u304b\u3089high-grade glioma\u3068\u3044\u3046\u3082\u306e\u3092\u9664\u3051\u3070\uff0c\u4e88\u5f8c\u306f\u671f\u5f85\u3067\u304d\u308b\u3068\u3044\u3046\u7d50\u8ad6\u3067\u3059\u3002<\/p>\n<h5>supratentorial PNET \u30c6\u30f3\u30c8\u4e0a\u306e\u80ce\u5150\u6027\u816b\u760d\u304c\u6368\u3066\u3089\u308c\u305f\u7406\u7531<\/h5>\n<p>PNET\u306f\uff0c\u672a\u5206\u5316\u306a\u5c0f\u578b\u7d30\u80de small round cells\u3001\u3042\u308b\u3044\u306f\u7570\u578b\u6027\u306e\u5f37\u3044\u6838\u3092\u6709\u3059\u308b\u7d30\u80de\u304c\u3001\u5bc6\u306b\u5897\u6b96\u3057\u3066\u5897\u6b96\u80fd (\u5206\u88c2\u50cf\uff0cMIB) \u304c\u7570\u5e38\u306b\u9ad8\u3044\u5927\u8133\u816b\u760d\u306e\u7dcf\u79f0\u3068\u3055\u308c\u307e\u3057\u305f\u3002\u3053\u306e\u4e2d\u306b\u306f\uff0c\u9ad8\u60aa\u6027\u5ea6\u30b0\u30ea\u30aa\u30fc\u30de\u3067\u9577\u671f\u751f\u5b58\u304c\u307b\u3068\u3093\u3069\u671b\u3081\u306a\u3044\u816b\u760d\u3084\u795e\u7d4c\u82bd\u816b\u304c\u304b\u306a\u308a\u306e\u983b\u5ea6\u3067\u542b\u307e\u308c\u3066\u3044\u305f\u307e\u3057\u305f\u3002\u5316\u5b66\u7642\u6cd5\u611f\u53d7\u6027\u304c\u9ad8\u304f\u6cbb\u308b\u30b1\u30fc\u30b9\u3082\u3042\u3063\u305f\u306e\u3067\u3059\u3002\u30b0\u30ea\u30aa\u30fc\u30de\u3078\u306e\u5206\u5316\u304c\u898b\u3089\u308c\u6838\u7570\u578b\u6027\u304c\u9ad8\u3044\u3082\u306e\u306f\u3088\u308a\u6cbb\u7642\u62b5\u6297\u6027\u3068\u3044\u3046\u6027\u8cea\u304c\u3042\u308a\u307e\u3059\u3002\u5927\u8133PNET\u306e\u8a3a\u65ad\u540d\u306e\u4e0b\u3067\uff0c\u795e\u7d4c\u82bd\u816b\u3068\u81a0\u82bd\u816b\u304c\u6df7\u5728\u3057\u3066\u6cbb\u7642\u3055\u308c\u3066\u3044\u305f\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n<h5>\u6cbb\u7642\u306f<\/h5>\n<ul>\n<li>\u6b8b\u5ff5\u306a\u304c\u3089\u5c0f\u5150\u8133\u816b\u760d\u306e\u4e2d\u3067\u3082\u60aa\u6027\u5ea6\u304c\u9ad8\u304f\u3066<span style=\"color: #000080;\"><strong>\u6cbb\u7642\u3082\u96e3\u3057\u3044<\/strong><\/span>\u3082\u306e\u3067\u3059<\/li>\n<li>\u3067\u3082\u52a9\u304b\u308b\u30c1\u30e3\u30f3\u30b9\u306f\u3042\u308a\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u3068\u3066\u3082\u65e9\u304f\u9032\u884c\u3057\u307e\u3059<\/strong><\/span>\u304b\u3089\u307e\u305a\u6cbb\u7642\u3092\u6025\u304e\u307e\u3059<\/li>\n<li>\u4e16\u754c\u7684\u306b\u3082<span style=\"color: #000080;\"><strong>\u78ba\u7acb\u3055\u308c\u305f\u6cbb\u7642\u65b9\u6cd5\uff08\u6a19\u6e96\u6cbb\u7642\uff09\u306f\u3042\u308a\u307e\u305b\u3093<\/strong><\/span><\/li>\n<li>\u6cbb\u7642\u306f\u305d\u308c\u305e\u308c\u306e\u5b50\u4f9b\u306e\u5e74\u9f62\u3068\u816b\u760d\u306e\u5834\u6240\u3067\u9055\u3044\u307e\u3059\u3057\uff0c\u3082\u306e\u3059\u3054\u304f\u8907\u96d1\u3067\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\u6cbb\u7642\u306f\u500b\u3005\u306e\u60a3\u8005\u3055\u3093\u3067\u30c6\u30a4\u30e9\u30fc\u30e1\u30a4\u30c9\uff08\u3044\u308d\u3044\u308d\uff09\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>\u307e\u305a\u624b\u8853\u3067\u3067\u304d\u308b\u3060\u3051\u3068\u308a\u307e\u3059\u304c\uff0c<span style=\"color: #000080;\"><strong>\u3059\u3054\u304f\u51fa\u8840\u3059\u308b\u304b\u3089\u5c0f\u3055\u3044\u5b50\u4f9b\u306b\u306f\u5371\u967a\u304c\u5927\u304d\u304f<\/strong><\/span>\u3066\uff0c\u3053\u306e\u3088\u3046\u306a\u816b\u760d\u306b\u6163\u308c\u305f\u8133\u5916\u79d1\u533b\u306b\u3057\u304b\u3067\u304d\u307e\u305b\u3093<\/li>\n<li>2018\u5e74\u6642\u70b9\u3067\u306f\uff0c\u81a0\u82bd\u816b\u306b\u8fd1\u3044\u50cf\u3092\u5448\u3059\u308b\u3082\u306e\u3068\u795e\u7d4c\u82bd\u816b\u306b\u985e\u4f3c\u3059\u308b\u5c0f\u578b\u7d30\u80de\u3067\u5f62\u6210\u3055\u308c\u308b\u3082\u306e\u3068\u3067\u306f\uff0c\u6cbb\u7642\u65b9\u6cd5\u304c\u304b\u306a\u308a\u7570\u306a\u308b\u306e\u3067\uff0c\u75c5\u7406\u8a3a\u65ad\u3092\u78ba\u5b9f\u306b\u884c\u3044\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u6838\u7570\u5f62\u6210\uff08\u9000\u5f62\u6210\uff09\u306e\u5f37\u3044\u3082\u306e\u306f\u81a0\u82bd\u816b\u306b\u6e96\u3058\u3066\uff0c\u5c0f\u578b\u5186\u5f62\u6838\u3092\u4e3b\u4f53\u3068\u3059\u308b\u3082\u306e\u306f\u9ac4\u82bd\u816b\u306b\u6e96\u3058\u3066\u6cbb\u7642\u3057\u307e\u3059<\/strong><\/span><\/li>\n<li>\u624b\u8853\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u3068\u5224\u65ad\u3059\u308c\u3070\uff0c\u5148\u306b\u5316\u5b66\u7642\u6cd5\uff08\u5236\u304c\u3093\u5264\uff09\u3067\u5c0f\u3055\u304f\u3057\u3066\u304b\u3089\u6458\u51fa\u3059\u308b\u65b9\u6cd5\u3082\u3042\u308a\u307e\u3059\uff0c\u3067\u3082\u6b8b\u5ff5\u306a\u304c\u3089\u5236\u304c\u3093\u5264\u304c\u52b9\u304f\u3053\u3068\u306f\u591a\u304f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u3044\u305a\u308c\u306b\u305b\u3088\u6700\u7d42\u7684\u306b\u306f\u6b8b\u3063\u3066\u3044\u308b<span style=\"color: #000080;\"><strong>\u816b\u760d\u3092\u624b\u8853\u3067\u5168\u90e8\u3068\u308a\u5207\u3089\u306a\u3044\u3068\u6cbb\u3089\u306a\u3044<\/strong><\/span>\u3068\u8003\u3048\u305f\u65b9\u304c\u3044\u3044\u3067\u3059<\/li>\n<li>\u6c34\u982d\u75c7\u306b\u5bfe\u3059\u308b\u30b7\u30e3\u30f3\u30c8\u624b\u8853\u306f\u304a\u8179\u306e\u4e2d\u3078\u306e\u8ee2\u79fb\u3092\u4fc3\u3059\u6050\u308c\u304c\u3042\u308a\u307e\u3059\u304b\u3089\u306a\u308b\u3079\u304f\u3057\u306a\u3044<\/li>\n<li>\u624b\u8853\u5f8c\u306f\u3067\u304d\u308b\u9650\u308a\u65e9\u304f\u5316\u5b66\u7642\u6cd5\u3092\u958b\u59cb\u3057\u307e\u3059<\/li>\n<li>\u5316\u5b66\u7642\u6cd5\u306f\u3044\u308d\u3044\u308d\u306a\u3082\u306e\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u3053\u308c\u3068\u3044\u3063\u305f\u6c7a\u3081\u624b\u306b\u306a\u308b\u3082\u306e\u306f\u77e5\u3089\u308c\u3066\u3044\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #000080;\"><strong>\u5316\u5b66\u7642\u6cd5\u3060\u3051\u3067\u306f\u6cbb\u3089\u306a\u3044\u306e\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u3082\u5fc5\u8981<\/strong><\/span>\u3067\u3059<\/li>\n<li>\u3067\u3082\uff0c\u5c0f\u3055\u306a\u5b50\u4f9b\u306b\u3067\u304d\u308b\u304b\u3089<span style=\"color: #000080;\"><strong>\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u526f\u4f5c\u7528\u306f\u5f37\u304f\u51fa\u307e\u3059<\/strong><\/span><\/li>\n<li>\u9ac4\u6db2\u64ad\u7a2e\u3067\u518d\u767a\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u304b\u3089\uff0c\u5168\u90e8\u306e\u8133\u3068\u810a\u9ac4\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u91cd\u5ea6\u306e\u653e\u5c04\u7dda\u969c\u5bb3\u3092\u907f\u3051\u308b\u305f\u3081\u306b\u306f\u306a\u308b\u3079\u304f\u5c11\u306a\u3044\u7dda\u91cf\u3092\u4f7f\u308f\u3056\u308b\u3092\u5f97\u307e\u305b\u3093<\/li>\n<li>\u3057\u304b\u3057\uff0c\u904e\u53bb\u306e\u8ad6\u6587\u3067\u306f\u8133\u810a\u9ac4\u7167\u5c04\u306f35\u30b0\u30ec\u30a4\u307b\u3069\u4f7f\u7528\u3055\u308c\u3066\u3044\u307e\u3059\uff0c\u3053\u308c\u3092\u5b89\u6613\u306b\u6e1b\u91cf\u3059\u308b\u3053\u3068\u306f\u96e3\u3057\u3044\u3067\u3059<\/li>\n<li>\uff13\u6b73\u672a\u6e80\u306e\u5b50\u4f9b\u305f\u3061\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u3067\u5316\u5b66\u7642\u6cd5\u3060\u3051\u3067\u6cbb\u7642\u3059\u308b\u3068\u3044\u3046\u306e\u304c\u4e16\u754c\u306e\u4e00\u822c\u7684\u306a\u8003\u3048\u65b9\u3067\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff13\u6b73\u3092\u8d8a\u3048\u3066\u304b\u3089\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3059<\/li>\n<li>\uff15\u5e74\u3092\u8d8a\u3048\u308b\u9577\u671f\u751f\u5b58\u306f40\uff05\u5f31\u3067\u3059<\/li>\n<li>\u5927\u8133\u306b\u3067\u304d\u307e\u3059\u304b\u3089\u3001<span style=\"color: #000080;\"><strong>\u5f8c\u907a\u75c7\u306f\u9ac4\u82bd\u816b\u3088\u308a\u3082\u91cd\u3044<\/strong><\/span>\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u5f8c\u907a\u969c\u5bb3\u3067\u6700\u3082\u554f\u984c\u3068\u306a\u308b\u306e\u306f<span style=\"color: #000080;\"><strong>\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3<\/strong><\/span>\uff08\u7cbe\u795e\u767a\u9054\u9045\u6ede\u3001\u77e5\u80fd\u969c\u5bb3\uff0c\u5b66\u7fd2\u969c\u5bb3\uff09\u3067\u3059<\/li>\n<li>\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3\u306f\u624b\u8853\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u3088\u3063\u3066\u751f\u3058\u307e\u3059<\/li>\n<li>\u5168\u8133\u7167\u5c04\u306b\u3088\u3063\u3066\u91cd\u3044\u8a8d\u77e5\u969c\u5bb3\u304c\u6b8b\u308c\u3070\u793e\u4f1a\u7684\u306a\u81ea\u7acb\u306f\u3067\u304d\u307e\u305b\u3093<\/li>\n<li>\u3067\u3059\u304b\u3089\u4e0a\u8863\u816b\u3068\u540c\u3058\u3088\u3046\u306b\uff0c\u64ad\u7a2e\u306e\u3053\u3068\u306f\u8003\u3048\u306b\u5165\u308c\u306a\u3044\u3067\uff0c<span style=\"color: #000080;\"><strong>\u304b\u306a\u308a\u3057\u307c\u3063\u305f\u9818\u57df\u306b\u3060\u3051\u653e\u5c04\u7dda\u6cbb\u7642\u3059\u308b\uff08\u5c40\u6240\u7167\u5c04\uff09\u3068\u3044\u3046\u9078\u629e\u80a2\u306f\u3042\u308a\u307e\u3059<\/strong><\/span><\/li>\n<li>\u6cbb\u7642\u5f8c\u306b\u4e0b\u5782\u4f53\u30db\u30eb\u30e2\u30f3\u306e\u5206\u6ccc\u304c\u60aa\u304f\u306a\u308b\u3053\u3068\u304c\u591a\u3044\u306e\u3067\u5c0f\u5150\u5185\u5206\u6ccc\u306e\u5148\u751f\u306e\u5354\u529b\u304c\u5fc5\u8981\u3067\u3059<\/li>\n<li>\u6700\u4f4e\u3067\u3082\u6570\u30f6\u6708\u306e\u6bcd\u5b50\u5165\u9662\u306b\u306a\u308b\u3053\u3068\u306f\u907f\u3051\u3089\u308c\u307e\u305b\u3093\u304b\u3089\u5bb6\u65cf\u3067\u3088\u304f\u76f8\u8ac7\u3057\u3066\u304a\u6bcd\u3055\u3093\u3068\u60a3\u5150\u3092\u9577\u671f\u5165\u9662\u3055\u305b\u308b\u8a08\u753b\u3092\u7acb\u3066\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u3053\u308c\u3089\u306e\u6cbb\u7642\u306f\u5c0f\u5150\u8133\u816b\u760d\u3092\u305f\u304f\u3055\u3093\u6271\u3063\u305f\u7d4c\u9a13\u306e\u3042\u308b\u533b\u5e2b\u306b\u3057\u304b\u3067\u304d\u307e\u305b\u3093<\/li>\n<\/ul>\n<h4>\u5178\u578b\u7684\u306a\u753b\u50cf\uff08\u81a0\u82bd\u816b\u306b\u8fd1\u3044\u75c5\u7406\u50cf\u306e\u4f8b\uff09<\/h4>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pnet\/pnetpre.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pnet\/pnetpre.png\" alt=\"\" width=\"211\" height=\"232\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pnet\/pnetpost.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/pnet\/pnetpost.png\" alt=\"\" width=\"198\" height=\"230\" \/><\/a><\/p>\n<p>\u7279\u306b\u60aa\u6027\u5ea6\u306e\u9ad8\u304b\u3063\u305fPNET\u306eMRI\u753b\u50cf\u3067\u3059\u3002\u75c5\u7406\u306f\u81a0\u82bd\u816b\u306b\u8fd1\u3044\u7d44\u7e54\u50cf\u3067\u3057\u305f\u3002\u3053\u306e\u5b50\u306f\uff14\u6b73\u3067\u3057\u305f\u3002\u5c0f\u3055\u3044\u5b50\u4f9b\u306b\u3067\u304d\u307e\u3059\u304c\u767a\u898b\u3055\u308c\u305f\u3068\u304d\u306b\u306f\u5de8\u5927\u306a\u816b\u760d\u306b\u306a\u3063\u3066\u3057\u307e\u3063\u3066\u3044\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u3002\u3053\u306e\u816b\u760d\u306e\u521d\u56de\u624b\u8853\u306e\u6642\u306b\u306f\u3042\u3075\u308c\u308b\u3088\u3046\u306b\u51fa\u8840\u3057\u307e\u3057\u305f\u3002\u6cbb\u7642\u306f\uff0c\u624b\u8853\u3067\u306a\u308b\u3079\u304f\u5168\u90e8\u53d6\u3089\u306a\u3044\u3068\u306a\u308a\u307e\u305b\u3093\u3002\u3067\u3082\u3053\u3093\u306a\u306b\u5927\u304d\u3044\u306e\u3092\u624b\u8853\u3067\u3044\u3063\u307a\u3093\u306b\u53d6\u308b\u3068\u547d\u304c\u5371\u306a\u3044\u3057\uff0c\u6458\u51fa\u3067\u304d\u3066\u3082\u969c\u5bb3\u304c\u5927\u304d\u304f\u306a\u308a\u3059\u304e\u307e\u3059\u304b\u3089\uff0c\u5316\u5b66\u7642\u6cd5\u3084\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u5c0f\u3055\u304f\u3057\u3066\u304a\u3044\u3066\u304b\u3089\uff0c\u958b\u982d\u624b\u8853\u3067\u5168\u90e8\u6458\u51fa\u3059\u308b\u3068\u3044\u3046\u65b9\u6cd5\u3082\u3042\u308a\u307e\u3059\u3002\u3053\u306e\u5b50\u4f9b\u306f\u305d\u3046\u3057\u307e\u3057\u305f\u3002\u3082\u3057\uff13\u6b73\u4ee5\u4e0b\u3060\u3068\u653e\u5c04\u7dda\u304c\u4f7f\u3044\u306b\u304f\u3044\u306e\u3067\u5316\u5b66\u7642\u6cd5\u3060\u3051\u306b\u306a\u308a\u307e\u3059\u304c\uff0c\u3044\u305a\u308c\u306b\u3057\u3066\u3082PNET\u306e\u6cbb\u7642\u306f\u96e3\u3057\u3044\u3067\u3059\u3002<br \/>\n\u8133\u810a\u9ac4\u7167\u5c04\u3068\u5316\u5b66\u7642\u6cd5\u3067\u6291\u3048\u8fbc\u3093\u3067\uff0c\u53f3\u306e\u5199\u771f\u306f\u6cbb\u7642\u5f8c10\u5e74\u7d4c\u3063\u305f\u3068\u304d\u306e\u3082\u306e\u3067\u3059\u3002\u5927\u304d\u304f\u306a\u3063\u3066\u304b\u3089\u306f\uff0c\u9ad8\u6b21\u8133\u6a5f\u80fd\u969c\u5bb3\u3068\u96e3\u6cbb\u6027\u3066\u3093\u304b\u3093\u3067\u5b66\u6821\u3078\u901a\u3046\u306e\u304c\u96e3\u3057\u304f\u306a\u308a\u307e\u3057\u305f\u3002<\/p>\n<h4>\u5178\u578b\u7684\u306a\u753b\u50cf\uff08\u672a\u5206\u5316\u80ce\u5150\u6027\u816b\u760d\u306e\u7d44\u7e54\u50cf\u3092\u6301\u3064\u3082\u306e\uff09<\/h4>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-5915\" title=\"pnetit3\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit3-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-5916\" title=\"pnetit5\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit5-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit5-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit5-300x298.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit5-550x546.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit5.jpg 750w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-5917\" title=\"pnetit4\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit4-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><\/p>\n<p>\u982d\u75db\u3068\u5614\u5410\u3067\u307f\u3064\u304b\u3063\u305f\u5e74\u9577\u515010\u6b73\u306ePNET\u3067\u3059\u3002\u8133\u5916\u79d1\u306e\u5148\u751f\u306b\u4e0a\u624b\u306b\u624b\u8853\u3067\u5168\u6458\u51fa\u3057\u3066\u3044\u305f\u3060\u3044\u3066\uff0c\u3059\u3050\u306b\u8133\u810a\u9ac4\u7167\u5c0425.2\u30b0\u30ec\u30a414\u5206\u5272\u3068\u5c40\u6240\u8ffd\u52a0\u7167\u5c0430\u30b0\u30ec\u30a415\u5206\u5272\u306e\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u305d\u306e\u5f8c\u306b\u76f8\u8ac7\u306b\u6765\u3089\u308c\u305f\u306e\u3067\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u5316\u5b66\u7642\u6cd5\u309224\u30b3\u30fc\u30b9\u8ffd\u52a0\u3057\u307e\u3057\u305f\u3002<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-5918\" title=\"pnetit2\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit2-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-5919\" title=\"pnetit1\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnetit1-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><\/p>\n<p>\u816b\u760d\u306f\u6d88\u5931\u3057\u3066\u5143\u6c17\u306b\u5b66\u6821\u3078\u901a\u3048\u3066\u3044\u307e\u3059\u3002\u6cbb\u7642\u5f8cIQ\u306f108\u3042\u308b\u306e\u3067\u3059\u304c\uff0c\u53f3\u306e\u524d\u982d\u8449\u306e\u4e0a\u524d\u982d\u56de\u3068\u3044\u3046\u6240\u306b\u767a\u751f\u3057\u305f\u306e\u304c\u5e78\u3044\u3067\u3042\u3063\u305f\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u3053\u306e\u5834\u6240\u306f\u78ba\u5b9f\u306b\u6458\u51fa\u3067\u304d\u308b\u304b\u3089\u3067\u3059\u3002<\/p>\n<h4>\u00a0\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u307b\u3068\u3093\u3069\u52b9\u304b\u306a\u304b\u3063\u305f\u4f8b\uff08\u9ad8\u60aa\u6027\u5ea6\u30b0\u30ea\u30aa\u30fc\u30de\u306b\u985e\u4f3c\u3059\u308b\u3082\u306e\uff09<\/h4>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnethy11.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-5921\" title=\"pnethy1\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnethy11-295x300.jpg\" alt=\"\" width=\"295\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnethy11-295x300.jpg 295w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnethy11.jpg 425w\" sizes=\"auto, (max-width: 295px) 100vw, 295px\" \/><\/a><br \/>\n\u624b\u8853\u3067\u7c21\u5358\u306b\u3068\u308c\u305d\u3046\u306aPNET\u3067\u3059\u3002\u5b9f\u969b\u306b\u5168\u6458\u51fa\u3057\u3066\u3044\u305f\u3060\u3044\u3066\uff0c\u3059\u3050\u306b\u8133\u810a\u9ac4\u7167\u5c04\u3068\u816b\u760d\u5e8a\u7167\u5c0454\u30b0\u30ec\u30a4\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u305f\u306e\u3067\u3059\u304c\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u6700\u4e2d\u306b\u624b\u8853\u6458\u51fa\u3057\u305f\u5834\u6240\u304b\u3089\u518d\u767a\u3057\u3066\u3057\u307e\u3044\u307e\u3057\u305f\u3002\u518d\u624b\u8853\u3067\u6458\u51fa\u3057\u3066\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u3092\u57fa\u5264\u3068\u3057\u305f\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u3084\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u4f7f\u3044\u307e\u3057\u305f\u304c\uff0c\u9593\u3082\u306a\u304f\u6fc0\u3057\u3044\u8133\u810a\u9ac4\u64ad\u7a2e\u3092\u751f\u3058\u307e\u3057\u305f\u3002MIB-1\u306f70%\u3067\uff0c\u81a0\u82bd\u816b\u306e\u3088\u3046\u306b\u5f37\u3044anaplasty\u304c\u3042\u308a\u307e\u3057\u305f\u3002<br \/>\n\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u6700\u3082\u5f37\u529b\u306a\u6cbb\u7642\u624b\u6bb5\u306a\u306e\u3067\u3059\u304c\uff0c\u5168\u304f\u7121\u52b9\u306aPNET\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n<h3><strong><span style=\"color: #ff0000;\">peripheral PNET<\/span><span style=\"color: #000080;\">\uff08Ewing&#8217;s sarcoma \u30e6\u30fc\u30a4\u30f3\u30b0\u8089\u816b\uff09<\/span><\/strong><\/h3>\n<ul>\n<li>pPNET\u3068\u7565\u3055\u308c\u307e\u3059\u304c\uff0c\u8133\u306b\u767a\u751f\u3059\u308bPNET\u3068\u306f\u7570\u306a\u308b\u816b\u760d\u3067\u3059\u304b\u3089\u6ce8\u610f\u3057\u3066\u4e0b\u3055\u3044<\/li>\n<li>pPNET\u306f\u982d\u9838\u90e8\u3067\u306f\uff0c<span style=\"color: #000080;\"><strong>\u5c0f\u5150\u3068\u82e5\u5e74\u6210\u4eba\u306e\u9ac4\u819c\u3084\u982d\u84cb\u5e95<\/strong><\/span>\u306b\u767a\u751f\u3057\u307e\u3059<\/li>\n<li>\u3044\u308f\u3086\u308bCNS PNET\u3068\u306f\u7570\u306a\u3063\u305f\u4e88\u5f8c\u304c\u3042\u308a\u7570\u306a\u3063\u305f\u6cbb\u7642\u6cd5\u304c\u7528\u3044\u3089\u308c\u307e\u3059\u3057\uff0c\u6cbb\u7642\u306e\u56fd\u969b\u5171\u540c\u7814\u7a76\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u30e6\u30fc\u30a4\u30f3\u30b0\u8089\u816b\u306b\u6e96\u3058\u305f\u5316\u5b66\u7642\u6cd5\u3092\u3057\u307e\u3059<\/li>\n<li>\u3082\u3061\u308d\u3093\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u5fc5\u8981\u306a\u3082\u306e\u3067\u3059<\/li>\n<li>\u7b2c11\u67d3\u8272\u4f53\u306812\u67d3\u8272\u4f53\u306e\u9593\u3067\u306etranslocation\u304c\u751f\u3058\u305f\u7d50\u679c\u306eEWS&#8211;FLI1 fusion gene\u304c\u539f\u56e0\u3068\u3057\u3066\u660e\u3089\u304b\u306b\u306a\u3063\u3066\u3044\u307e\u3059<\/li>\n<li>Euro-E.W.I.N.G.\u00a099 clinical trial\u3068\u3044\u3046\u7814\u7a76\u3067565\u4eba\u306e\u60a3\u8005\u3055\u3093\u306e\u3053\u306e\u816b\u760d\u907a\u4f1d\u5b50\u306e\u5909\u7570\u306e\u30bf\u30a4\u30d7 (fusion types)\u3068\u518d\u767a\u307e\u3067\u306e\u671f\u9593\u304c\u8abf\u3079\u3089\u308c\u307e\u3057\u305f\u304c\uff0c\u4e88\u5f8c\u306b\u5dee\u306f\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059<\/li>\n<li>Children&#8217;s Oncology Group (COG)\u306e\u7814\u7a76\u3067\u3082\u907a\u4f1d\u5b50\u5909\u7570\u306e\u30bf\u30a4\u30d7\u3067\u306f\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u3084\u5168\u751f\u5b58\u5272\u5408\u306b\u5909\u308f\u308a\u306f\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059<\/li>\n<\/ul>\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed?term=%22Le%20Deley%20MC%22%5BAuthor%5D\">Le Deley MC<\/a>\u00a0et al. Impact of EWS-ETS fusion type on disease progression in Ewing&#8217;s sarcoma\/peripheral primitive neuroectodermal tumor: prospective results from the cooperative Euro-E.W.I.N.G. 99 trial. J Clin Oncol 2010<br \/>\n<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed?term=%22van%20Doorninck%20JA%22%5BAuthor%5D\">van Doorninck JA<\/a>, et al.: Current treatment protocols have eliminated the prognostic advantage of type 1 fusions in Ewing sarcoma: a report from the Children&#8217;s Oncology Group. J Clin Oncol 2010<\/p>\n<h5>peripheral PNET: Ewing Sarcoma<\/h5>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnettm1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-7983\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnettm1-300x201.jpg\" alt=\"pnettm1\" width=\"300\" height=\"201\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnettm1-300x201.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnettm1-550x369.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnettm1.jpg 567w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnettm2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-7984\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnettm2-300x203.jpg\" alt=\"pnettm2\" width=\"300\" height=\"203\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnettm2-300x203.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnettm2-550x372.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pnettm2.jpg 567w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>EWS&#8211;FLI1 fusion gene\u304c\u3042\u3063\u305f\u4f8b\u3067\u3059\u3002\u6838\u80de\u4f53\u6bd4\u304c\u3068\u3066\u3082\u5927\u304d\u306a\u672a\u5206\u5316\u816b\u760d\u3067\u3059\u3002neuroblastoma\u3068\u8a00\u3063\u3066\u3082\u3088\u3044\u6240\u898b\u3067\uff0c\u82e5\u5e74\u8005\u306e\u5074\u982d\u90e8\u306e\u786c\u819c\u306b\u767a\u751f\u3057\u307e\u3057\u305f\u3002peripheral PNET\u306f\uff0c\u9aa8\u8edf\u90e8\u7d44\u7e54\u306b\u767a\u751f\u3059\u308bEwing sarcoma\u3068\u540c\u3058\u3082\u306e\u3067\u3059\u3002\u8133\u306b\u767a\u751f\u3059\u308bCNS PNET\u3068\u306f\u767a\u751f\u8d77\u6e90\u304c\u7570\u306a\u308a\u307e\u3059\u3002\u3067\u3082\u6cbb\u7642\u65b9\u6cd5\u306f\u540c\u3058\u3067\u3057\u3087\u3046\u3002\u6fc0\u3057\u3044\u64ad\u7a2e\u6027\u8cea\u3092\u6709\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<h3><strong><span style=\"color: #ff0000;\">2\u6b21\u816b\u760d\u3068\u3057\u3066\u306ePNET<\/span><\/strong><\/h3>\n<p>2005\u5e74\u306e\uff15\u6708\u304b\u3089\uff17\u6708\u306b\u304b\u3051\u3066\u7d9a\u3051\u3066\uff13\u4eba\u306e\u5b50\u4f9b\u305f\u3061\u306ePNET\u306e\u76f8\u8ac7\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\uff13\u4eba\u3068\u3082\u5c0f\u3055\u3044\u9803\u306b\u767d\u8840\u75c5\u3092\u60a3\u3063\u3066\u5316\u5b66\u7642\u6cd5\u3068\u4e2d\u67a2\u795e\u7d4c\u3078\u306e\u4f4e\u7dda\u91cf\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u3066\uff0c\u767d\u8840\u75c5\u304c\u6cbb\u3063\u3066\u304b\u3089\u4f55\u5e74\u3082\u305f\u3063\u3066\u3044\u307e\u3057\u305f\u3002\u5927\u8133\u306bPNET\u304c\u767a\u751f\u3057\u305f\u306e\u3067\u3059\u304c\u7279\u5fb4\u304c\u3042\u3063\u3066\uff0cPNET\u306e\u75c5\u7406\u7d44\u7e54\u306e\u4e2d\u306b<span style=\"color: #000080;\"><strong>\u81a0\u82bd\u816bglioblastoma\u306e\u6210\u5206\u304c\u5165\u3063\u3066\u3044\u308b<\/strong><\/span>\u3068\u306e\u3053\u3068\u3067\u3057\u305f\u3002\u3053\u306e\u3088\u3046\u306a\uff12\u6b21\u816b\u760d secondary cancer\u3068\u3057\u3066\u306ePNET\u306f\u3068\u3066\u3082\u6cbb\u3057\u306b\u304f\u3044\u3082\u306e\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>\u901a\u5e38\u306ePNET\u3088\u308a\u3082\u60aa\u6027\u5ea6\u304c\u3055\u3089\u306b\u9ad8\u3044\u816b\u760d\u3067\u3059<\/strong><\/span>\u3057\uff0c\u307e\u3060\u5b50\u4f9b\u3067\u5341\u5206\u306a\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3067\u304d\u306a\u3044\u4e0a\u306b\uff0c\u767d\u8840\u75c5\u6cbb\u7642\u306e\u305f\u3081\u306b\u3059\u3067\u306b\u5168\u8133\u810a\u9ac4\u7167\u5c04\u304c\u884c\u306a\u308f\u308c\u3066\u3044\u308b\u305f\u3081\u3067\u3082\u3042\u308a\u307e\u3059\u3002\u904e\u53bb\u306b\u3082\u540c\u3058\u3088\u3046\u306a\u4f8b\u3092\uff13\u4f8b\u898b\u305f\u3053\u3068\u304c\u3042\u3063\u3066\uff0c\u5076\u7136\u306b\u3057\u3066\u306f\u6570\u304c\u591a\u3059\u304e\u308b\u306e\u3067\u3059\u304c\uff0c\u767d\u8840\u75c5\u6cbb\u7642\u306e\u5f8c\u306e\uff12\u6b21\u8133\u816b\u760d\u306e\u767a\u751f\u7387\u304c\u6c17\u306b\u306a\u308a\u307e\u3059\u30022\u6b21\u816b\u760d\uff082\u6b21\u764c\uff09\u3068\u3057\u3066\u751f\u3058\u308b<span style=\"color: #000080;\"><strong>PNET\u306e\u5831\u544a\u306f\uff0c\u307b\u3068\u3093\u3069\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u305f\u5b50\u4f9b\u305f\u3061\u3067\u3059<\/strong><\/span>\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u3060\u3051\u3068\u3044\u3046\u306e\u306f\u6975\u3081\u3066\u4f8b\u5916\u7684\u3067\u3059\u304b\u3089\uff0c\u3053\u308c\u3092\u653e\u5c04\u7dda\u8a98\u767a\u816b\u760d\u3068\u306f\u8a00\u3048\u307e\u305b\u3093\u3002<\/p>\n<h5>PNET\u306e\u6587\u732e\u60c5\u5831<\/h5>\n<\/div>\n<h4>\u5206\u5b50\u5206\u985e<\/h4>\n<p>Sturm D, et al.: New Brain Tumor Entities Emerge from Molecular Classification of CNS-PNETs. Cell 164:1060-1072, 2016<br \/>\nCNS-PNET\u306b\u306f\u4ed6\u306e\u8133\u816b\u760d\u306e\u65e2\u77e5\u306e\u5206\u5b50\u7279\u6027 molecular profile \u3092\u6301\u3064\u3082\u306e\u3082\u591a\u3044\u306e\u3067\u3059\u304c\uff0cPNET\u306b\u7279\u6709\u306a\u5206\u5b50\u7279\u6027\u3068\u81e8\u5e8a\u50cf\u3092\u793a\u3059\u3082\u306e\u304c4\u7a2e\u985e\u3042\u308b\u305d\u3046\u3067\u3059\u3002<br \/>\n1.\u00a0CNS neuroblastoma with FOXR2 activation (CNS NB-FOXR2)<br \/>\n2. CNS Ewing sarcoma family tumor with CIC alteration (CNS EFT-CIC)<br \/>\n3. CNS high-grade neuroepithelial tumor with MN1 alteration (CNS HGNET-MN1)<br \/>\n4. CNS high-grade neuroepithelial tumor with BCOR alteration (CNS HGNET-BCOR)<br \/>\n\u6cbb\u7642\u53cd\u5fdc\u6027\u304c\u7570\u306a\u308b\u3053\u3068\u304c\u793a\u5506\u3055\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u5b9f\u969b\u7684\u306a\u6cbb\u7642\u306e\u9078\u629e\u306f\u3053\u308c\u304b\u3089\u3067\u3059\u3002<\/p>\n<div class=\"setumei\">\n<h4><strong>\u518d\u767a\u306b\u5bfe\u3059\u308b\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306e\u52b9\u679c<\/strong><\/h4>\n<p>Cefalo G, et al: Temozolomide is an active agent in children with recurrent medulloblastoma\/primitive neuroectodermal tumor: an Italian multi-institutional phase II trial. Neuro Oncol 16: 748-53, 2014<br \/>\n\u518d\u767a\u3057\u305f\u9ac4\u82bd\u816b\u3042\u308b\u3044\u306fPNET\u306e42\u4eba\u306e\u5b50\u3069\u3082\u305f\u3061\u304c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3067\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u3002120-200m2\u3092\uff15\u65e5\u9593\u4f7f\u7528\u3059\u308b\u666e\u901a\u306e\u4f7f\u3044\u65b9\u3067\u3059\u30026\u4eba\u3067\u816b\u760d\u304c\u6d88\u5931\u3057\u307e\u3057\u305f\uff08\u5b8c\u5168\u594f\u529f\uff09\uff0c11\u4eba\u3067\u90e8\u5206\u594f\u529f\uff0c10\u4eba\u3067\u5909\u5316\u304c\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002PFS\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f\uff16\u30f6\u6708\u306742\uff05\uff0c1\u5e74\u306717%\u3067\u3057\u305f\u3002\u3053\u308c\u3089\u306e\u5b50\u3069\u3082\u305f\u3061\u306f\u521d\u671f\u6cbb\u7642\u3067\u304b\u306a\u308a\u304d\u3064\u3044\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u3066\u3044\u308b\u306b\u3082\u304b\u304b\u308f\u3089\u305a\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u304c\u3042\u308b\u7a0b\u5ea6\u306e\u6709\u52b9\u6027\u3092\u793a\u3057\u305f\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4><strong>\uff14\u6b73\u672a\u6e80\u3078\u306e\u5316\u5b66\u7642\u6cd5\u306e\u52b9\u679c<\/strong><\/h4>\n<p>Friedrich C, et al.: Treatment of young children with CNS-primitive neuroectodermal tumors\/pineoblastomas in the prospective multicenter trial HIT 2000 using different chemotherapy regimens and radiotherapy. Neuro Oncol 15: 224-234, 2013<br \/>\n2001\u5e74\u304b\u30892005\u5e74\u306b\uff0c4\u6b73\u672a\u6e80\u306ePNET8\u4eba\uff0c\u4e0a\u8863\u82bd\u816b 1\u4eba\uff0c\u677e\u679c\u4f53\u82bd\u816b 8\u4eba\u304c\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u8ee2\u79fb\u306e\u306a\u304411\u4eba\u306b\u306f\uff0c8\u30f6\u6708\u9593\u30675\u30b5\u30a4\u30af\u30eb\u306eHIT-SKK\u5316\u5b66\u7642\u6cd5\u3068\u8133\u810a\u9ac4\u7167\u5c04 CSI\u3067\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u3002\u64ad\u7a2e\u8ee2\u79fb\u306e\u3042\u3063\u305f6\u4eba\u3067\u306f\uff0c\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\u3068\u30a8\u30c8\u30dd\u30b7\u30c9\u306e\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u306b\u826f\u3044\u53cd\u5fdc\u304c\u3042\u3063\u305f\u4f8b\u3067\u5927\u91cf\u5316\u5b66\u7642\u6cd5 HDCT\u304c\u52a0\u3048\u3089\u308c\u307e\u3057\u305f\u3002\u3053\u306e\u5316\u5b66\u7642\u6cd5\u306e\u9593\u306b\u8133\u5ba4\u5185\u306b\u30e1\u30bd\u30c8\u30ec\u30ad\u30bb\u30fc\u30c8 MTX\u304c\u6295\u4e0e\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u306b\u53cd\u5fdc\u3057\u306a\u304b\u3063\u305f\u4f8b\u3068HDCT\u306e\u5f8c\u3067\u6b8b\u5b58\u816b\u760d\u304c\u3042\u3063\u305f\u4f8b\u306b\u306f\u8133\u810a\u9ac4\u7167\u5c04\u304c\u52a0\u3048\u3089\u308c\u307e\u3057\u305f\u3002\uff15\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u3068\u5168\u751f\u5b58\u5272\u5408\u306f\uff0c24%\u306840%\u3067\u3057\u305f\u3002\u8ee2\u79fb\u306e\u306a\u304b\u3063\u305f\u60a3\u515011\u4eba\u3067\u306f\uff0c\u305f\u30601\u4eba\u3067\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u306e\u9593\u306b\u75c5\u6c17\u306e\u9032\u884c relapse\/progression\u304c\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u8ee2\u79fb\u306e\u3042\u3063\u305f6\u4eba\u306e\u3046\u3061\uff0cHDCT\u3068CSI\u304c\u53ef\u80fd\u3067\u3042\u3063\u305f3\u4eba\u3067\u5b8c\u5168\u5bdb\u89e3\u304c\u7dad\u6301\u3067\u304d\u307e\u3057\u305f\u3002\u8ad6\u6587\u3092\u3088\u304f\u8aad\u3080\u3068\uff0cPNET\u304c4\u4eba (50%)\u751f\u5b58\u3057\u3066\u3044\u3066\uff0c\u677e\u679c\u4f53\u82bd\u816b\u304c3\u4eba (37%)\u751f\u5b58\u3057\u3066\u3044\u307e\u3059\u3002\u3053\u306e\u5185\uff0c7\u30f6\u6708\u767a\u75c7\u306ePNET\u306e\u7537\u5150\u3068\uff0c9\u30f6\u6708\u767a\u75c7\u306e\u677e\u679c\u4f53\u82bd\u816b\u306e\u5973\u51501\u4eba\u3067\u8133\u810a\u9ac4\u7167\u5c04\u3092\u884c\u308f\u306a\u305a\u306b\u6e08\u3093\u3067\u3044\u307e\u3059\u3002\u3044\u305a\u308c\u3082\u64ad\u7a2e\u8ee2\u79fb\u304c\u306a\u3044\u4f8b\u3067\u3042\u308a\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3067\u306f\u306a\u304f\u3066\uff0c\u6a19\u6e96\u7684\u306aSKK\u3092\u53d7\u3051\u3066\u3044\u307e\u3059\u3002\u8457\u8005\u306f\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u65b9\u304c\u3044\u3044\u3093\u3058\u3083\u306a\u3044\u304b\u306a (seems to be superior) \u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u304c\uff0c\u3068\u3066\u3082\u305d\u3046\u3068\u306f\u89e3\u91c8\u3067\u304d\u307e\u305b\u3093\u3002<\/p>\n<p>SKK\u306f\uff0c1. CPH\/VCR, 2. MTX\/VCR, 3. MTX\/VCR, 4. CBDCA\/VCR\u306e\u901a\u5e38\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u3067\u3059\u30021-4\u30923\u30b5\u30a4\u30af\u30eb\u884c\u3063\u3066\u304b\u30891\u30684\u30922\u30b5\u30a4\u30af\u30eb\u884c\u3046\u3082\u306e\u3067\u3059\u3002<\/p>\n<h4><strong>\u8133\u810a\u9ac4\u7167\u5c04\u3092\u3057\u306a\u3044\u3067\u5c40\u6240\u7167\u5c04\u306b\u3068\u3069\u3081\u308b\u3068\u3044\u3046\u610f\u898b<\/strong><\/h4>\n<p>Massimino M, et al.: Evolving of therapeutic strategies for CNS-PNET. Pediatr Blood Cancer 60:2031-2035, 2013<br \/>\nPNET\u306b\u95a2\u3059\u308b\u65b0\u305f\u306a\u6cbb\u7642\u6210\u7e3e\u3092\u793a\u3059\u8ad6\u6587\u306f\u306a\u304b\u306a\u304b\u51fa\u307e\u305b\u3093\u3002Massimino\u3089\u306f\uff0c2000\u5e74\u304b\u3089\u30c6\u30f3\u30c8\u4e0aPNET28\u4eba\u3092\u6cbb\u7642\u3057\u307e\u3057\u305f\u3002\u65b9\u6cd5\u3068\u3057\u3066\uff0cMTX, VP-16, CPA, CBDCA, VCR\u306e\u5316\u5b66\u7642\u6cd5\uff0c\u591a\u5206\u5272\u8133\u810a\u9ac4\u7167\u5c0431-39\u30b0\u30ec\u30a4\uff0cthiotepa\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u7528\u3044\u307e\u3057\u305f\u3002\u5f8c\u5e74\u3067\u306f\u8ee2\u79fb\u306e\u306a\u3044\u3082\u306e\u306b\u306f\u8133\u810a\u9ac4\u7167\u5c04\u3092\u6b62\u3081\u3066\u5c40\u6240\u7167\u5c04 (focal RT 54Gy) \u3092\u884c\u3063\u3066\u3044\u307e\u3059\u3002 \u7d50\u679c\u3068\u3057\u3066\uff0c5\u5e74EFS\u306f53%\uff0c5\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f52%\u3067\u3057\u305f\u3002\u7d50\u8ad6\u3068\u3057\u3066\uff0cLocal control is the main goal of treatment for CNS-PNET. \u3068\u8a18\u8f09\u3055\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u79c1\u306f\u3053\u306e\u610f\u898b\u306b\u8cdb\u6210\u3067\u3059\u3002<\/p>\n<h4><strong>\u518d\u767a\u306b\u5bfe\u3059\u308b\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u8840\u6db2\u5e79\u7d30\u80de\u6551\u63f4 HDC with HSCR<\/strong><\/h4>\n<p>Raghuram CP, Moreno L, Zacharoulis S : Is there a role for high dose chemotherapy with hematopoietic stem cell rescue in patients with relapsed supratentorial PNET? J Neurooncol. 2011 [Epub]<br \/>\n2011\u5e74\u306bRaghuram\u304c\uff0c\u4e73\u515015\u4f8b\uff0c\u677e\u679c\u4f53\u82bd\u816b15\u4f8b\u3092\u542b\u3080\uff0c\u8a0846\u4f8b\u306e\u518d\u767asPNET\u3078\u306eHDC with HSCR\u306e\u6cbb\u7642\u6210\u7e3e\u3092\u307e\u3068\u3081\u307e\u3057\u305f\u300215\u4f8b\u304c\u751f\u5b58\u3057\u3066\u304a\u308a\uff0c\u305d\u306e\u5185\u306e13\u4f8b\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3044\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u4e2d\u3067\u30823\u6b73\u672a\u6e80\u306e\u60a3\u5150\u306e12\u30f6\u6708\u5168\u751f\u5b58\u5272\u5408\u306f67%\u3068\u9ad8\u304f\uff0c\u4e00\u65b9\u3067\u677e\u679c\u4f53\u82bd\u816b\u306e\u751f\u5b58\u5272\u5408\u306f\u4f4e\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u7d50\u8ad6\u3068\u3057\u3066\uff0c\u518d\u71c3PNET\u306b\u5bfe\u3059\u308bHDC\u306f\u5e7c\u5150\u4f8b\u306b\u304a\u3044\u3066\u751f\u5b58\u304c\u671f\u5f85\u3067\u304d\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u884c\u308f\u306a\u304f\u3066\u3082\u3088\u3044\u4f8b\u304c\u3042\u308b\u3002\u9006\u306b\u5e74\u9577\u5150\u3068\u677e\u679c\u4f53\u90e8PNET\u3067\u306f\u3053\u306e\u6cbb\u7642\u6cd5\u3067\u306e\u6cbb\u7642\u6210\u7e3e\u306f\u6975\u3081\u3066\u60aa\u3044\u3068\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4><strong>PNET\u3068\u677e\u679c\u4f53\u82bd\u816b\u306b\u306f\u5225\u306e\u539f\u56e0\u907a\u4f1d\u5b50\u304c\u3042\u308b<\/strong><\/h4>\n<p>Miller S. et al.: Genome-wide molecular characterization of central nervous system primitive neuroectodermal tumor and pineoblastoma. Neuro Oncol 13:866-79, 2011<br \/>\nPNET\u306e\u65b9\u304cpineoblastoma\u3088\u308agenimic imbalance\u304c\u591a\u3044\u3002gain of PCDHGA3, 5q31.3 \u304cPNET\u306e62.1%\u3068pineoblastoma\u306e100%\uff0cFAM129A, 1q25\u304cPNET\u306e55.2%\u3068pineoblastoma\u306e50%\u306b\u691c\u51fa\u3055\u308c\u305f\u3002CDKN2A\/B (9p21.3) \u6b20\u5931\u3068\u4e88\u5f8c\u4e0d\u826f\u4f8b\u3068\u306e\u76f8\u95a2\u6027\u304c\u3042\u308b\u3002PNET\u306b\u306f\u9855\u8457\u306amolecular heterogeneity\u304c\u3042\u308b\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002 2011\u5e74\u6642\u70b9\u3067\u306e\u5831\u544a\u3067\u3059\u304c\uff0cPNET\u3068pineoblastoma\u306e\u816b\u760d\u95a2\u9023\u907a\u4f1d\u5b50\u306b\u95a2\u3057\u3066\u306f\u3053\u306e\u7a0b\u5ea6\u306e\u89e3\u6790\u306b\u7559\u307e\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4><strong>PNET\u306b\u5bfe\u3059\u308b\u30ea\u30b9\u30af\u7fa4\u5206\u985e\u6cbb\u7642<\/strong><\/h4>\n<p>Chintagumpala M, et al.: A pilot study of risk-adapted radiotherapy and chemotherapy in patients with supratentorial PNET. Neuro Oncol 11: 33-44, 2009<br \/>\n1996-2003\u5e74\u306e\u9593\u306b16\u4eba\u306e\u60a3\u5150\u304c\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u3002\u9ad8\u30ea\u30b9\u30af\u7fa4\u306f\u9ac4\u82bd\u816b\u3068\u540c\u69d8\u306b\uff0c\u8853\u5f8c\u306e\u6b8b\u5b58\u816b\u760d\u3084\u9ac4\u6db2\u64ad\u7a2e\u306e\u5b58\u5728\u3067\u5206\u985e\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u6a19\u6e96\u30ea\u30b9\u30af\u7fa4\u306b\u306f23.4\u30b0\u30ec\u30a4\u306e\u8133\u810a\u9ac4\u7167\u5c04\uff0c\u9ad8\u30ea\u30b9\u30af\u7fa4\u306b\u306f36-39.6\u30b0\u30ec\u30a4\u306e\u8133\u810a\u9ac4\u7167\u5c04\u3067\uff0c\u816b\u760d\u306e\u539f\u767a\u90e8\u4f4d\u306b\u306f55.8\u30b0\u30ec\u30a4\u304c\u4f7f\u7528\u3055\u308c\u307e\u3057\u305f\u3002\u3053\u306e\u7167\u5c04\u306e\u3042\u3068\u3067\u5168\u3066\u306e\u60a3\u5150\u306f\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff0c\u30b7\u30af\u30ed\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\u3092\u7528\u3044\u305f\u5e79\u7d30\u80de\u6551\u63f4\u306b\u3088\u308b\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u3066\u3044\u307e\u3059\u3002\uff15\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f73%\u3067\u3057\u305f\u304c\uff0c\u6a19\u6e96\u30ea\u30b9\u30af\u7fa4\u3067\u306f88%\uff0c\u9ad8\u30ea\u30b9\u30af\u7fa4\u3067\u306f58%\u3068\u5dee\u304c\u3042\u308a\u307e\u3059\u3002\u5316\u5b66\u7642\u6cd5\u6b7b\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002<br \/>\n\u89e3\u8aac\uff1a16\u4eba\u4e2d\u306e\uff17\u4eba\u304c\u4e00\u822c\u7684\u306b\u306fPNET\u3068\u8a3a\u65ad\u3055\u308c\u306a\u3044\u677e\u679c\u4f53\u82bd\u816b\u3067\u3059\u3002\u3067\u3059\u304b\u3089\uff0cPNET\u306e\u6cbb\u7642\u6210\u7e3e\u3068\u8aad\u307f\u53d6\u308b\u3053\u3068\u306f\u3067\u304d\u307e\u305b\u3093\u3002\u904e\u53bb\u306b\u306f\uff0cPNET\u306e\u8133\u810a\u9ac4\u7167\u5c04\u306f35\u30b0\u30ec\u30a4\u304f\u3089\u3044\u304c\u6a19\u6e96\u7684\u306a\u7dda\u91cf\u3067\u3057\u305f\u304b\u3089\uff0c\u6a19\u6e96\u30ea\u30b9\u30af\u7fa4\u3092\u533a\u5225\u3057\u306623.4\u30b0\u30ec\u30a4\u306b\u7dda\u91cf\u3092\u843d\u3068\u3057\u3066\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u4f75\u7528\u3057\uff15\u5e74\u3067\u306e\u5168\u751f\u5b58\u5272\u5408\u304c88%\u3068\u3044\u3046\u306e\u306f\u3088\u3044\u6210\u7e3e\u3067\u3057\u305f\u3002\u3057\u304b\u3057\uff0c\u3055\u3089\u306b\u3088\u304f\u8aad\u3080\u3068\uff0c\u6a19\u6e96\u30ea\u30b9\u30af\u7fa4\u306e\u771f\u306ePNET\u306f\uff16\u4f8b\u306e\u307f\u3067\uff0c\u5e74\u9f62\u306f3.6-8.8\u6b73\u3067\u3059\u3002\u3053\u308c\u304c\u672c\u5f53\u304b\u3069\u3046\u304b\u304c\u78ba\u304b\u3081\u3089\u308c\u308b\u306e\u306f\u307e\u3060\u307e\u3060\u5c06\u6765\u306e\u3053\u3068\u3067\u3059\u3002\u5927\u8133PNET\u306f\u9ac4\u82bd\u816b\u3088\u308a\u3082\u3055\u3089\u306b\u304a\u305d\u308d\u3057\u3044\u816b\u760d\u3067\u3042\u308b\u3053\u3068\u3092\u5fd8\u308c\u3066\u306f\u306a\u308a\u307e\u305b\u3093\u3002<\/p>\n<h4><strong>\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u8840\u6db2\u5e79\u7d30\u80de\u6551\u63f4<\/strong><\/h4>\n<p>Fangusaro J, et al.: Intensive chemotherapy followed by consolidative myeloablative chemotherapy with autologous hematopoietic cell rescue (AuHCR) in young children with newly diagnosed supratentorial primitive neuroectodermal tumors (sPNETs): report of the Head Start I and II experience. Pediatr Blood Cancer.\u00a050:312-8, 2008<br \/>\n2002\u5e74\u307e\u3067\u306eHead Start I and II\u306e\u6210\u7e3e\u3067\u3059\u3002\u521d\u671f\u6cbb\u7642\u306b\u5927\u91cf\u5316\u5b66\u7642\u6cd5 consolidative myeloablative chemotherapy\u3092\u4f7f\u7528\u3059\u308b\u3082\u306e\u3067\u3059\u3002\u7d50\u8ad6\u3068\u3057\u306643\u4f8b\u4e2d\u306e20\u4f8b 47\uff05\u304c\u751f\u5b58\u3057\u3066\u3044\u3066\uff0c\u5185\u306e12\u4f8b 28%\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u306a\u3044\u3067\u6e08\u307f\u307e\u3057\u305f\u3002<\/p>\n<h4><strong>PNET\u306b\u5bfe\u3059\u308b\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u5f79\u5272<\/strong><\/h4>\n<p>Timmermann B, et al.: Role of radiotherapy in supratentorial primitive neuroectodermal tumor in young children: results of the German HIT-SKK87 and HIT-SKK92 trials. J Clin Oncol 24: 1554-1560,\u00a02006<br \/>\nPNET\u306e\u6cbb\u7642\u6210\u7e3e\u306e\u8ad6\u6587\u306f\u306a\u304b\u306a\u304b\u3067\u306a\u3044\u306e\u3067\u3059\u304c\u3053\u308c\u306f\u6a29\u5a01\u306e\u9ad8\u3044\u96d1\u8a8c\u306b\u767a\u8868\u3055\u308c\u305f\u30c9\u30a4\u30c4\u3068\u30aa\u30fc\u30b9\u30c8\u30ea\u30a2\u306e\u6210\u7e3e\u3067\u3059\u3002\uff13\u6b73\u672a\u6e80\u306e29\u4eba\u306e\u3053\u3069\u3082\u304c\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u3002\u5168\u4f8b\u306b\u5316\u5b66\u7642\u6cd5\u304c\u4f7f\u7528\u3055\u308c\u3066\u3044\u3066\uff0c15\u4eba\u306e\u5b50\u4f9b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u305a14\u4eba\u306e\u5b50\u4f9b\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u8ffd\u52a0\u3055\u308c\u307e\u3057\u305f\u3002\u5316\u5b66\u7642\u6cd5\u306f\uff0c\u30e1\u30c8\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8\uff08MTX\uff09\u3092\u57fa\u5264\u3068\u3059\u308b\u3082\u306e\u306a\u3069\u304c\u4f7f\u7528\u3055\u308c\u3066\u3044\u307e\u3059\u3002 \uff13\u5e74\u5168\u751f\u5b58\u5272\u5408\uff08\u751f\u5b58\u7387\uff09\u306f17%\u3067\uff0c\uff13\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\uff08\u518d\u767a\u306a\u3057\uff09\u306f15%\u3067\u3057\u305f\u3002\u3067\u3059\u304b\u3089\uff13\u5e74\u4ee5\u5185\u306b\uff18\u5272\u4ee5\u4e0a\u306e\u5b50\u4f9b\u304c\u4ea1\u304f\u306a\u3063\u3066\u3044\u307e\u3059\u300229\u4eba\u4e2d\u306e24\u4eba\u306b\u518d\u767a\uff08\u518d\u71c3\uff09\u304c\u3042\u308a\uff0c13\u4f8b\u3067\u306f\u816b\u760d\u306e\u3042\u3063\u305f\u5834\u6240\uff0c\uff13\u4f8b\u3067\u306f\u816b\u760d\u304b\u3089\u306f\u6163\u308c\u305f\u5834\u6240\u3078\u306e\u64ad\u7a2e\uff0c\uff18\u4f8b\u3067\u306f\u4e21\u65b9\u306b\u3042\u308a\u307e\u3057\u305f\u3002\u3067\u3059\u304b\u3089\u5c40\u6240\u518d\u767a\u306f21\/29\u306772%\u306b\u3082\u304a\u3088\u3076\u306e\u3067\u3059\u3002\u653e\u5c04\u7dda\u3092\u53d7\u3051\u306a\u304b\u3063\u305f\u5b50\u4f9b\u306e\u5185\u306e\u305f\u3060\uff11\u4eba\u306e\u307f\u304c\u751f\u5b58\u3057\u305f\u3068\u66f8\u3044\u3066\u3042\u308a\u307e\u3059\u3002 \u624b\u8853\u3067\u5168\u6458\u51fa\u3067\u6765\u305f\u5b50\u4f9b\u306e\u751f\u5b58\u7387\u304c\u9ad8\u3044\u3060\u308d\u3046\u3053\u3068\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3063\u3066\u3082\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u3068\u6cbb\u7642\u6210\u7e3e\u306f\u60aa\u3044\u3053\u3068\uff0c\uff13\u6b73\u672a\u6e80\u306e\u5b50\u4f9b\u305f\u3061\u3067\u5316\u5b66\u7642\u6cd5\u3092\u3057\u3066\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u5f85\u3064\u3068\u3057\u3066\u3082\uff16\u30f6\u6708\u304c\u9650\u754c\u3067\u3042\u308d\u3046\u3068\u7d50\u8ad6\u3055\u308c\u3066\u3044\u307e\u3059\u3002<br \/>\n\u305d\u306e\u5f8c\uff0c\u3053\u306e\u8ad6\u6587\u306b\u5bfe\u3057\u3066Larouche V\u3068\u3044\u3046\u4eba\u304c\u53cd\u8ad6\u3057\u307e\u3057\u305f\u3002\u300c \u3060\u304b\u3089\u3068\u8a00\u3063\u3066\uff0c<strong><span style=\"color: #ff0000;\">\uff13\u6b73\u4ee5\u4e0b\u306e\u5b50\u4f9b\u306b\u5168\u8133\u810a\u9ac4\u7167\u5c04\u3092\u3059\u308b\u3068\u8a31\u5bb9\u3067\u304d\u306a\u3044\u8a8d\u77e5\u969c\u5bb3\u304c\u751f\u3058\u308b<\/span><\/strong>\u3002Timmermann\u3089\u304c\u52e7\u3081\u3066\u3044\u308b35Gy\u5168\u8133\u810a\u9ac4\u306854Gy\u5c40\u6240\u7167\u5c04\u306f20\u5e74\u524d\u306b\u8a71\u3092\u623b\u3059\u3053\u3068\u3067\u3042\u308b\u3002\u3060\u304b\u3089\u5e79\u7d30\u80de\u79fb\u690d\u3092\u4f7f\u7528\u3059\u308b\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u8a66\u307f\u308b\u6642\u3067\u3042\u308b\u3002\u300d\u3068\u8ff0\u3079\u3066\u3044\u307e\u3059\u3002\u305d\u306e\u5f8c\uff0cTimmermann\u304c\u53cd\u8ad6\u3057\u307e\u3057\u305f\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306a\u3057\u3067\u816b\u760d\u304c\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3067\u304d\u3066\u3044\u308b\u3068\u3044\u3046\u5831\u544a\u304c\u307b\u3068\u3093\u3069\u306a\u3044\u306e\u3067\u3042\u308b\u3068\u3002 \u3053\u306e\u8ad6\u4e89\u306f\u5c3d\u304d\u307e\u305b\u3093\u3002\u9078\u629e\u3067\u304d\u306a\u3044\u9078\u629e\uff0c\u547d\u3092\u3068\u308b\u304b\u77e5\u80fd\u3092\u3068\u308b\u304b\u306e\u7591\u554f\u3092\u6295\u3052\u304b\u3051\u308b\u3070\u304b\u308a\u3067\u3059\u3002\u3069\u3061\u3089\u304c\u3044\u3044\u3068\u5272\u308a\u5207\u308c\u308b\u554f\u984c\u3067\u306f\u306a\u304f\uff0c\u500b\u3005\u306e\u60a3\u8005\u3055\u3093\u306e\u5e74\u9f62\u3092\u542b\u3081\u305f\u30ea\u30b9\u30af\u3068\u816b\u760d\u306e\u90e8\u4f4d\u3068\u624b\u8853\u306e\u7d50\u679c\u3068\u8003\u3048\u5408\u308f\u305b\u3066\uff0c\u4e00\u4eba\u3072\u3068\u308a\u306e\u4e21\u89aa\u3068\u8a71\u3057\u5408\u308f\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u307e\u305f\u653e\u5c04\u7dda\u6cbb\u7642\u306754Gy\u304b\u3051\u308b\u304b\u3069\u3046\u304b\uff0c\u3069\u306e\u304f\u3089\u3044\u306e\u9818\u57df\u306b\u7167\u5c04\u3059\u308b\u306e\u304b\u3082\u9055\u3063\u3066\u304d\u307e\u3059\u3002\u5358\u7d14\u306a\u30d7\u30ed\u30c8\u30b3\u30fc\u30eb\u3067\u6cbb\u7642\u304c\u6c7a\u3081\u3089\u308c\u308b\u308f\u3051\u306f\u306a\u3044\u306e\u3067\u3059\u3002<\/p>\n<h4><strong>3\u6b73\u672a\u6e80\u306ePNET\u306b\u5bfe\u3059\u308b\u4f75\u7528\u5316\u5b66\u7642\u6cd5<\/strong><\/h4>\n<p>Geyer JR, et al: Maltiagent chemotherapy and deferred radiotherapy in infants with malignant brain tumors: a report from the Children&#8217;s Cancer Group. J Clin Oncol 23: 7621-31, 2005<br \/>\n\u7c73\u56fd\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002299\u4f8b\u306e<span style=\"color: #000080;\"><strong>\uff13\u6b73\u672a\u6e80<\/strong><\/span>\u306e\u60aa\u6027\u8133\u816b\u760d\u306e\u5b50\u4f9b\u305f\u3061\u306b\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff0c\u30b7\u30af\u30ed\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9\u3042\u308b\u3044\u306f\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\uff0c\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\uff0c\u30a4\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9\u306e\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3063\u305f\u6210\u7e3e\u3067\u3059\u3002PNET\u306e\u5b50\u4f9b\u306f46\u4f8b\u3067\u3059\u304c10\u4f8b\u306e\u677e\u679c\u4f53\u90e8\u816b\u760d\u304c\u542b\u307e\u308c\u3066\u3044\u307e\u3059\u3002\u624b\u8853\u306790%\u4ee5\u4e0a\u53d6\u308c\u305f\u306e\u306f18\u4f8b\u306e\u307f\u3067\u3057\u305f\u3002\u5316\u5b66\u7642\u6cd5\u306e\u594f\u529f\u7387 (CR\/PR) \u306f43%\u3067\u3057\u305f\u3002\uff15\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\uff08\u518d\u767a\u306a\u3057\u3067\uff15\u5e74\u904e\u3054\u3059\uff09\u306f\uff0c\u9ac4\u82bd\u816b\u306732%.\uff0cPNET\u306717%\uff0c\u4e0a\u8863\u816b\u306732%\uff0cAT\/RT(rhabdoid tumor)\u306714% \u3067\u3057\u305f\u3002PNET46\u4f8b\u306e\uff15\u5e74\u5168\u751f\u5b58\u5272\u5408\uff08\uff15\u5e74\u306e\u6642\u70b9\u3067\u751f\u304d\u6b8b\u3063\u3066\u3044\u308b\uff09\u306f31%\u3067\u3057\u305f\u30028\u4f8b(17%)\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u306a\u3044\u3067\u518d\u767a\u306a\u304f\uff15\u5e74\u9593\u751f\u5b58\u3057\u3066\u3044\u307e\u3059\u3002 \u3053\u3053\u3067\u4f7f\u308f\u308c\u3066\u3044\u308b\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u306f\u79c1\u306e\u4f7f\u7528\u3057\u3066\u3044\u305fICE\u5316\u5b66\u7642\u6cd5\uff08\u30a4\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9\uff09\u3068\u30b9\u30da\u30af\u30c8\u30e9\u30e0\u304c\u3068\u3066\u3082\u4f3c\u3066\u3044\u307e\u3059\u3002\u5316\u5b66\u7642\u6cd5\u3092\u99c6\u4f7f\u3057\u3066\u3082\u7d50\u5c40\u306e\u3068\u3053\u308d\u5927\u90e8\u5206\u306e\u5b50\u4f9b\u305f\u3061\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3055\u308c\u3066\u3044\u3066\uff0c\u751f\u5b58\u7387\u3082\u3068\u3066\u3082\u4f4e\u3044\u3068\u611f\u3058\u307e\u3057\u305f\u3002\u3067\u3082\uff0c\u3053\u306e\u3088\u3046\u306a\u5c0f\u3055\u306a\u5b50\u4f9b\u305f\u3061\u306b\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u3067\u304c\u3093\u3070\u3063\u3066\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u6642\u671f\u3092\u9045\u3089\u305b\u308b\u3068\u3044\u3046\u3053\u3068\u306f\u3068\u3066\u3082\u5927\u5207\u306a\u8a66\u307f\u3067\u3059\u3002<\/p>\n<h4>2005\u5e74\uff15\u6708\u56fd\u969b\u8133\u816b\u760d\u4f1a\u8b70<\/h4>\n<p>\u30b7\u30af\u30ed\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\u306e\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3063\u305f\u5f8c\u3067\uff0c\uff11\u30b3\u30fc\u30b9\u306e\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u5730\u56fa\u3081\u7642\u6cd5(consolidation)\u306b\u4f7f\u3063\u305f\u5831\u544a\u3067\u3059\u3002\u64ad\u7a2e\u304c\u3042\u308b\u75c7\u4f8b\u306b\u306f\u30e1\u30c8\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u304c\u4f7f\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u5316\u5b66\u7642\u6cd5\u3067\u816b\u760d\u304c\u5b8c\u5168\u6d88\u5931\u3057\u305f\u5834\u5408\u3068\uff16\u6b73\u672a\u6e80\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u884c\u308f\u305a\u306b\uff0c\u305d\u308c\u4ee5\u5916\u3067\u306f23.4\u30b0\u30ec\u30a4\u306e\u5168\u8133\u810a\u9ac4\u7167\u5c04\u304c\u8ffd\u52a0\u3055\u308c\u307e\u3057\u305f\u300212\u4f8b(28%)\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u884c\u3046\u3053\u3068\u304c\u306a\u304b\u3063\u305f\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u300243\u4f8b\u306e\u5927\u8133PNET\u304c\u6cbb\u7642\u3055\u308c\u3066\uff0c20\u4f8b(46.5%)\u304c\u816b\u760d\u304c\u306a\u3044\u72b6\u614b\u3067\u751f\u5b58\u3057\u3066\u3044\u308b\u3068\u767a\u8868\u3055\u308c\u307e\u3057\u305f\u3002 \u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u3067\u306e\u5316\u5b66\u7642\u6cd5\u304c\u539f\u56e0\u306e\u6b7b\u4ea1(induction death)\u306f3\u4f8b\u3067\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3067\u306e\u6b7b\u4ea1(consolidation death)\u306f\uff11\u4f8b\u3067\u3059\u304b\u3089\uff0c\u5168\u4f53\u3067\u306e\u5316\u5b66\u7642\u6cd5\u6b7b\u306f9%\u3067\u3059\u3002\u751f\u5b58\u3057\u3066\u3044\u308b\uff11\u4f8b(5%, 1\/20\u4f8b)\u3067\u767d\u8840\u75c5\u304c\u751f\u3058\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002 \u3055\u3089\u306b\u9577\u671f\u9593\u306e\u89b3\u5bdf\u304c\u884c\u308f\u308c\u308c\u3070\u751f\u5b58\u7387\u306f\u4e0b\u304c\u308a\u307e\u3059\u306e\u3067\uff0c\u3053\u306e\u6cbb\u7642\u6cd5\u3067\u3082\u9577\u671f\u751f\u5b58\u306f4\u5272\u5f31\u3068\u898b\u306a\u3055\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u5f93\u6765\u306e\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3068\u6bd4\u8f03\u3057\u3066\u5927\u304d\u306a\u30a4\u30f3\u30d1\u30af\u30c8\u306e\u3042\u308b\u6210\u7e3e\u3067\u306f\u306a\u3044\u3088\u3046\u306b\u601d\u3048\u307e\u3057\u305f\u3002\u64ad\u7a2e\u306e\u3042\u308b\u4f8b\u3067\u306f\u3084\u306f\u308a\u6975\u3081\u3066\u9ad8\u3044\u6b7b\u4ea1\u7387\u3068\u306a\u308a\u307e\u3059\u3002<\/p>\n<h5>supratentorial PNET\uff08\u30c6\u30f3\u30c8\u4e0a\u539f\u59cb\u795e\u7d4c\u5916\u80da\u8449\u6027\u6027\u816b\u760d\uff09\u306e\u96d1\u5b66<\/h5>\n<ul>\n<li>PNET\uff08\u539f\u59cb\u795e\u7d4c\u5916\u80da\u8449\u6027\u816b\u760d\uff09\u306f\uff0c1973\u5e74\u306bHart and Earle\u306b\u3088\u308a\u63d0\u5531\u3055\u308c\u307e\u3057\u305f<\/li>\n<li>\u75c5\u7406\u6240\u898b\u3067\u306f\uff0c\u5bc6\u306b\u5897\u6b96\u3059\u308b\u6975\u3081\u3066\u672a\u5206\u5316\u306a<span style=\"color: #000080;\"><strong>\u5c0f\u5f62\u5186\u5f62\u7d30\u80de(small round cell)<\/strong> <\/span>\u3092\u4e3b\u4f53\u3068\u3057\uff0c\u816b\u760d\u306e\u90e8\u5206\u50cf\u306b\u304a\u3044\u3066\u30b0\u30ea\u30a2\u3084\u795e\u7d4c\u7d30\u80de\u3078\u306e\u5206\u5316\u50be\u5411\u3092\u793a\u3059\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u60aa\u6027\u795e\u7d4c\u81a0\u816b\u306e\u7279\u5fb4\u3067\u3042\u308b\u51fa\u8840\u3084\u58ca\u6b7b\u3092\u4f34\u3044\uff0c\u6838\u5206\u88c2\u50cf\u306f\u591a\u304f\uff0cMIB-1\u67d3\u8272\u7387\u304c60%\u3092\u8d8a\u3048\u308b\u3053\u3068\u3082\u73cd\u3057\u304f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u6838\u7570\u578b nuclear anaplasia\u306e\u5f37\u3044\u3082\u306e\u307b\u3069\u6cbb\u7642\u62b5\u6297\u6027\u3067\u3042\u308b\u3068\u3044\u3046\u610f\u898b\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u81e8\u5e8a\u50cf\u3068\u3057\u3066\u306f\uff0c\u6025\u6fc0\u306b\u5897\u5927\u3057\u304b\u3064\u9ac4\u8154\u5185\u64ad\u7a2e\u3092\u304d\u305f\u3057\u3084\u3059\u3044\u3053\u3068\u304c\u7279\u5fb4\u3067\u3059<\/li>\n<li>\u3053\u308c\u3089\u306e\u7279\u5fb4\u306f\uff0c\u5c0f\u8133\u306b\u767a\u751f\u3059\u308b\u9ac4\u82bd\u816b\u3068\u985e\u4f3c\u3057\u3066\u3044\u307e\u3059\u304c\uff0c\u4e21\u8005\u306e\u6cbb\u7642\u6210\u7e3e\u3084\u751f\u7269\u5b66\u7684\u7279\u5fb4\u306e\u9055\u3044\u304b\u3089WHO\u5206\u985e\u306b\u304a\u3044\u3066\u306f\u305d\u308c\u305e\u308c\u72ec\u7acb\u3057\u305f\u75be\u60a3\u3068\u3057\u3066\u8a18\u8f09\u3057\u307e\u3057\u305f<\/li>\n<li>Gaffney\u3089\u306f\u5c0f\u5150\u8133\u816b\u760d\u306e\u7d042.5\uff05\u3068\u5831\u544a\u3057\u3066\u3044\u307e\u3059<\/li>\n<li>\u6210\u4eba\u4f8b\u306e\u5831\u544a\u3082\u3042\u308b\u3082\u306e\u306e\u6982\u306d10\u6b73\u4ee5\u4e0b\uff0c\u7279\u306b\uff15\u6b73\u672a\u6e80\u306e\u4e73\u5e7c\u5150\u306b\u591a\u304f\u767a\u751f\u3057\u307e\u3059<\/li>\n<li>\u767a\u751f\u90e8\u4f4d\u306f\u57fa\u5e95\u6838\u3092\u542b\u3080\u5927\u8133\u534a\u7403\u304c\u307b\u3068\u3093\u3069\u3092\u5360\u3081\u307e\u3059<\/li>\n<li>\u9ac4\u6db2\u3092\u4ecb\u3057\u3066\u306e\u64ad\u7a2e\u8ee2\u79fb\u3092\u751f\u3058\uff0c\u64ad\u7a2e\u306b\u3088\u308b\u6b7b\u4ea1\u7387\u304c\u6975\u3081\u3066\u9ad8\u3044\u60aa\u6027\u816b\u760d\u3067\u3059<\/li>\n<\/ul>\n<h4>\u8a3a\u65ad<\/h4>\n<ul>\n<li>\u982d\u75db\u3084\u5614\u5410\uff0c\u610f\u8b58\u969c\u5bb3\u306a\u3069\u306e\u982d\u84cb\u5185\u5727\u4ea2\u9032\u75c7\u72b6\u306b\u3066\u767a\u75c7\u3057\u307e\u3059<\/li>\n<li>\u767a\u898b\u3055\u308c\u305f\u6642\u306b\u306f\u3059\u3067\u306b\u5927\u8133\u534a\u7403\u306e\u5de8\u5927\u306a\u816b\u760d\u3068\u3057\u3066\u8a8d\u3081\u3089\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u968f\u4f34\u3059\u308b\u5927\u8133\u5de3\u75c7\u72b6\u306f\u816b\u760d\u306e\u767a\u751f\u90e8\u4f4d\u306b\u4f9d\u5b58\u3057\u307e\u3059<\/li>\n<li>\u610f\u8b58\u969c\u5bb3\u304c\u6025\u901f\u306b\u9032\u884c\u3057\u3066\u91cd\u7be4\u306a\u72b6\u614b\u306b\u9665\u308b\u3053\u3068\u3082\u3042\u308a\uff0c\u8a3a\u65ad\u3068\u6cbb\u7642\u3092\u6025\u304c\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u00a0\u5358\u7d14CT\u3067\u306f\uff0c\u6bd4\u8f03\u7684\u5883\u754c\u660e\u77ad\u3067\u7b49\u5438\u53ce\u57df\u3082\u3057\u304f\u306f\u9ad8\u5438\u53ce\u57df\u306e\u816b\u7624\u3068\u3057\u3066\u63cf\u51fa\u3055\u308c\uff0c\u5185\u90e8\u306b\u56a2\u80de\u3084\u58ca\u6b7b\u5de3\u3092\u793a\u3059\u4f4e\u5438\u53ce\u57df\u3092\u6df7\u5728\u3057\u307e\u3059<\/li>\n<li>CT\u3067\u306e\u9ad8\u5438\u53ce\u6240\u898b\u306f\u816b\u760d\u7d30\u80de\u5bc6\u5ea6\u304c\u9ad8\u3044\u3053\u3068\u3092\u53cd\u6620\u3057\u3066\u3044\u307e\u3059<\/li>\n<li>\u5de8\u5927\u306a\u56a2\u80de\u6027\u816b\u760d\u3068\u306a\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u816b\u760d\u5b9f\u8cea\u90e8\u5206\u306f\u5f37\u304f\u9020\u5f71\u3055\u308c\uff0c\u77f3\u7070\u5316\u3082\u7d04\u534a\u6570\u306b\u8a8d\u3081\u3089\u308c\u307e\u3059<\/li>\n<li>MRI\u3067\u306f\uff0cT1\u5f37\u8abf\u753b\u50cf\u3067\u4f4e\u4fe1\u53f7\u57df\u3068\u3057\u3066\u63cf\u51fa\u3055\u308c\uff0c\u816b\u760d\u5b9f\u8cea\u306f\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u306b\u3088\u308a\u5897\u5f37\u52b9\u679c\u3092\u793a\u3059\u5834\u5408\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u816b\u760d\u5468\u56f2\u8133\u6d6e\u816b\u306f\u5b58\u5728\u3059\u308b\u3082\u306e\u306e\u816b\u760d\u306e\u5927\u304d\u3055\u306b\u6bd4\u8f03\u3059\u308c\u3070\u8efd\u5ea6\u3067\u3059\uff0c\u3053\u306e\u70b9\u304c\u81a0\u82bd\u816b\u3084\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u3068\u306e\u9055\u3044\u304b\u3082\u3057\u308c\u307e\u305b\u3093<\/li>\n<li>\u8840\u7ba1\u306b\u5bcc\u307f\u51fa\u8840\u6027\u306e\u816b\u760d\u3067\u3042\u308b\u306e\u3067\u816b\u760d\u8840\u7ba1\uff08\u767a\u9054\u3057\u305f\u9759\u8108\uff09\u306eflow-void\u306e\u6240\u898b\u3092\u4f34\u3044\u307e\u3059<\/li>\n<li>\u9ac4\u8154\u5185\u64ad\u7a2e\u3092\u751f\u3058\u308b\u3053\u3068\u304c\u591a\u3044\u305f\u3081\u5168\u8133\u810a\u9ac4MRI\u306f\u5fc5\u9808\u3067\u3059<\/li>\n<li>\u53ef\u80fd\u3067\u3042\u308c\u3070\u6458\u51fa\u624b\u8853\u306e\u6642\u306b\u9ac4\u6db2\u7d30\u80de\u691c\u67fb\u3092\u3057\u307e\u3059<\/li>\n<\/ul>\n<h4>\u6cbb\u7642<\/h4>\n<ul>\n<li>PNET\u3092\u7591\u3048\u3070\u6cbb\u7642\u306e\u958b\u59cb\u3092\u6025\u3050\u3053\u3068\u304c\u809d\u8981\u3067\u3059<\/li>\n<li>\u57fa\u672c\u7684\u306a\u6cbb\u7642\u65b9\u91dd\u3068\u3057\u3066\uff0c\u307e\u305a\u958b\u982d\u624b\u8853\u306b\u3088\u308b\u6458\u51fa\u3068\u8853\u5f8c\u306e\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3092\u8a08\u753b\u3057\u307e\u3059<\/li>\n<li>\u75c7\u4f8b\u6570\u304c\u5c11\u306a\u3044\u3053\u3068\u304b\u3089\u6a19\u6e96\u5316\u3055\u308c\u305f\u6cbb\u7642\u65b9\u6cd5\u306f\u306a\u304f\uff0c\u5927\u898f\u6a21\u306a\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u306e\u7d50\u679c\u5831\u544a\u3082\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u75c5\u7406\u6240\u898b\u3068\u81e8\u5e8a\u50cf\u306e\u985e\u4f3c\u6027\u304b\u3089\u9ac4\u82bd\u816b\u306b\u6e96\u3058\u305f\u6cbb\u7642\u65b9\u6cd5\u304c\u9078\u629e\u3055\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u306e\u3067\u3059\u304c\uff0c\u6c7a\u3081\u624b\u3068\u306a\u308b\u6cbb\u7642\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u4f53\u91cd\u306e\u5c11\u306a\u3044\u5e7c\u5c0f\u5150\u306b\u767a\u751f\u3059\u308b\u5927\u304d\u306a\u6613\u51fa\u8840\u6027\u306e\u8133\u816b\u760d\u3067\u3042\u308a\u5468\u8fba\u8133\u3068\u306e\u5883\u754c\u3082\u660e\u3089\u304b\u3067\u306f\u306a\u304f\uff0c\u307e\u305f\u624b\u8853\u6458\u51fa\u7387\u306f\u4e88\u5f8c\u3092\u5927\u304d\u304f\u5de6\u53f3\u3059\u308b\u305f\u3081\uff0c\u624b\u8853\u306b\u306f\u719f\u7df4\u3057\u305f\u8853\u8005\u304c\u3042\u305f\u3089\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u624b\u8853\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u3068\u5224\u65ad\u3055\u308c\u308b\u5834\u5408\u306b\u306f\uff0c\u5b9a\u4f4d\u8133\u624b\u8853\u306b\u3088\u308a\u75c5\u7406\u8a3a\u65ad\u3092\u884c\u3044\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3084\u5316\u5b66\u7642\u6cd5\u3092\u5148\u884c\u3055\u305b\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u816b\u760d\u7e2e\u5c0f\u304c\u5f97\u3089\u308c\u305f\u5f8c\u306b\u6458\u51fa\u8853\u304c\u53ef\u80fd\u3068\u5224\u65ad\u3055\u308c\u308c\u3070\uff0c\u3084\u306f\u308a\u958b\u982d\u624b\u8853\u306b\u3066\u5168\u6458\u51fa\u3092\u306f\u304b\u3063\u305f\u65b9\u304c\u826f\u3044\u3067\u3059<\/li>\n<li>\u7a4d\u6975\u7684\u816b\u760d\u6458\u51fa\u8853\u306b\u3088\u308a\u982d\u84cb\u5185\u5727\u4ea2\u9032\u75c7\u72b6\u306e\u5bdb\u89e3\u3068\u75c5\u7406\u8a3a\u65ad\u3092\u5f97\u305f\u5f8c\u306b\u306f\uff0c\u3067\u304d\u3046\u308b\u9650\u308a\u65e9\u304f\u8853\u5f8c\u306e\u88dc\u52a9\u7642\u6cd5\u3092\u884c\u3046\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u8853\u5f8c\u306e\u6570\u9031\u9593\uff0c\u75c5\u7406\u8a3a\u65ad\u306e\u305f\u3081\u306b\u5f85\u6a5f\u3057\u305f\u308a\u8853\u5f8c\u5408\u4f75\u75c7\u306e\u6cbb\u7642\u3092\u884c\u3063\u3066\u3044\u308b\u9593\u306b\uff0c\u816b\u760d\u306e\u8457\u660e\u306a\u518d\u5897\u5927\u306b\u906d\u9047\u3057\u305f\u306a\u3069\u3068\u3044\u3046\u3053\u3068\u306f\u7a00\u3067\u306f\u3042\u308a\u3042\u307e\u305b\u3093<\/li>\n<li>\u305f\u3068\u3048\u4e9c\u5168\u6458\u3084\u5168\u6458\u624b\u8853\u3092\u6210\u3057\u5f97\u3066\u3082\uff0c\u65e9\u671f\u518d\u71c3\u306e\u78ba\u7387\u306f\u975e\u5e38\u306b\u9ad8\u3044\u306e\u3067\uff0c\u983b\u56de\u306bMRI\u3092\u884c\u3063\u3066\u518d\u71c3\u306e\u6709\u7121\u3092\u78ba\u8a8d\u3057\u306a\u304c\u3089\u6cbb\u7642\u3092\u9032\u3081\u307e\u3059<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u5fc5\u9808\u3067\u3059<\/li>\n<li>54Gy\u7a0b\u5ea6\u306e\u816b\u760d\u5c40\u6240\u7167\u5c04\u3068\u8133\u810a\u9ac4\u7167\u5c04\u3092\u884c\u3044\u307e\u3059\u304c\uff0c\u8133\u810a\u9ac4\u7167\u5c04\u7dda\u91cf\u306f\u60a3\u5150\u306e\u5e74\u9f62\u306b\u3088\u3063\u3066\u614e\u91cd\u306b\u5224\u65ad\u3055\u308c\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u7279\u306b\uff13\u6b73\u672a\u6e80\u306e\u60a3\u5150\u306b\u95a2\u3057\u3066\u306f\u91cd\u7be4\u306a\u653e\u5c04\u7dda\u8133\u969c\u5bb3\u306e\u767a\u751f\u7387\u304c\u9ad8\u304f\uff0c\u8133\u810a\u9ac4\u7167\u5c04\u6642\u671f\u3092\uff13\u6b73\u307e\u3067\u5f85\u6a5f\u3059\u308b\u6cbb\u7642\u6cd5\u304c\u9078\u629e\u3055\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u6700\u3082\u554f\u984c\u3068\u306a\u308b\u8133\u810a\u9ac4\u7167\u5c04 craniospinal irradiation\u306e\u7dda\u91cf\u306f\u5f90\u3005\u306b\u4f4e\u4e0b\u50be\u5411\u306b\u306f\u3042\u308a\u307e\u3059<\/li>\n<li>Chintagumpala\u3089\u304c\u307e\u3068\u3081\u305f\u3068\u3053\u308d\u306b\u3088\u308c\u3070\uff0cReddy\u3089\u306f34-40Gy, Cohen\u3089\u306f36-40Gy, Albright\u3089\u306f\uff14\u6b73\u4ee5\u4e0a\u306736Gy\uff0c1.5\u6b73\u304b\u3089\uff13\u6b73\u306723.4Gy\uff0cTimmerman\u3089\u306f35.2Gy, Jakachi\u3089\u306f\uff14\u6b73\u4ee5\u4e0a\u306736Gy, Pizer\u3089\u306f36Gy, Massimino\u3089\u306f10\u6b73\u672a\u6e80\u306731.2Gy, 10\u6b73\u4ee5\u4e0a\u306739Gy, Chintagumpala\u3089\u306f\u6a19\u6e96\u30ea\u30b9\u30af\u306723.4Gy\uff0c\u9ad8\u30ea\u30b9\u30af\u306736-39.6Gy\u306e\u7dda\u91cf\u3092\u9078\u629e\u3057\u3066\u3044\u307e\u3059<\/li>\n<li>\u4e00\u822c\u7684\u306b\u306f\u5316\u5b66\u7642\u6cd5\u3092\u52a0\u3048\u308b\u3053\u3068\u304c\u591a\u3044\u306e\u3067\u3059\u304c\uff0c\u5316\u5b66\u7642\u6cd5\u306e\u6709\u52b9\u6027\u306f\u8a3c\u660e\u3055\u308c\u308b\u306b\u306f\u81f3\u3063\u3066\u3044\u307e\u305b\u3093<\/li>\n<li>\u9ac4\u82bd\u816b\u306b\u304a\u3044\u3066\uff15\u5e74\u751f\u5b58\u738780\uff05\u3068\u3044\u3046\u5831\u544a\u304c\u3042\u308b\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\uff0c\u30ed\u30e0\u30b9\u30c1\u30f3\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3063\u305f\u7d50\u679c\u3082\uff0cPNET\u306b\u304a\u3044\u3066\u306e\uff15\u5e74\u751f\u5b58\u7387\u306f37\uff05\u306b\u904e\u304e\u307e\u305b\u3093\u3067\u3057\u305f<\/li>\n<li>\u5e79\u7d30\u80de\u6551\u63f4\u3092\u4f75\u7528\u3059\u308b\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u6709\u7528\u6027\u304c\u691c\u8a0e\u3055\u308c\u3066\u3044\u308b\u304c\u9577\u671f\u6210\u7e3e\u306e\u5831\u544a\u306f\u5341\u5206\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u00a0\u6b27\u5dde\u3067\u306e\u5171\u540c\u7814\u7a76(German brain tumor trials HIT 88\/89 and 91)\u304b\u3089\uff0c\u30a4\u30d5\u30a9\u30de\u30a4\u30c9\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9\uff0c\u30e1\u30c8\u30c8\u30ec\u30ad\u30bb\u30a4\u30c8\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff0c\u30b7\u30bf\u30e9\u30d3\u30f3\u3092\u7167\u5c04\u524d\u306b\u6295\u4e0e\u3057\u305f40\u4f8b\u3068\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\uff0c\u30ed\u30e0\u30b9\u30c1\u30f3\u3092\u7167\u5c04\u5f8c\u306b\u4f7f\u7528\u3057\u305f23\u4f8b\u306e\u6210\u7e3e\u304c\u5831\u544a\u3055\u308c\u307e\u3057\u305f\u3002\u5168\u4f53\u3067\u306e\uff13\u5e74\u751f\u5b58\u5272\u5408\u306f48%\u3067\u3042\u308a\uff0c\u7167\u5c04\u524d\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3063\u305f\u7fa4\u306b\u65e9\u671f\u5897\u60aa\u4f8b\u304c\u591a\u304b\u3063\u305f\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u306f\uff0c\u8133\u810a\u9ac4\u7167\u5c0435Gy\u306b\u52a0\u3048\u3066\u816b\u760d\u5c40\u6240\u7dda\u91cf\u306f\u5c11\u306a\u304f\u3068\u308254Gy\u304c\u5fc5\u8981\u3067\u3042\u308b\u3068\u7d50\u8ad6\u3065\u3051\u3066\u3044\u307e\u3059\u3002<\/li>\n<li>\u3057\u304b\u3057\uff0c\u3053\u308c\u3089\u306e\u6cbb\u7642\u3092\u5341\u5206\u884c\u3063\u3066\u3082\u767a\u751f\u90e8\u4f4d\u3067\u306e\u5c40\u6240\u518d\u767a\u306f\u975e\u5e38\u306b\u591a\u3044\u306e\u304c\u73fe\u72b6\u3067\u3059<\/li>\n<\/ul>\n<h4>\u4e88\u5f8c<\/h4>\n<ul>\n<li>PNET\u306f\u6975\u3081\u3066\u6b7b\u4ea1\u7387\u306e\u9ad8\u3044\u75be\u60a3\u3067\u3059<\/li>\n<li>\u4e2d\u67a2\u795e\u7d4c\u7cfb\u5185\u8ee2\u79fb\u306e\u6709\u7121\u304c\u660e\u767d\u306a\u4e88\u5f8c\u4e0d\u826f\u56e0\u5b50\u3068\u306a\u308a\u307e\u3059<\/li>\n<li>188\u4f8b\u304c\u767b\u9332\u3055\u308c\u305fChildren&#8217;s Cancer Group Study 921\u306e\uff13\u5e74\u7121\u5897\u60aa\u751f\u5b58\u7387\u306f\uff0c\u8ee2\u79fb\u306e\u306a\u3044\u7fa4\u3067\u306f53%\u3067\u3042\u308a\uff0c\u8ee2\u79fb\u306e\u3042\u308b\u7fa4\u3067\u306f14%\u3068\u8457\u3057\u3044\u5dee\u304c\u3042\u308a\u307e\u3057\u305f<\/li>\n<li>PNET\u306e\u9577\u671f\u751f\u5b58\u4f8b\u3092\u6e09\u731f\u3059\u308c\u3070\uff0c\u958b\u982d\u624b\u8853\u306b\u3088\u308b\u5168\u6458\u51fa\u3068\u8133\u810a\u9ac4\u7167\u5c04\u306f\u6cbb\u7652\u3092\u6c42\u3081\u308b\u4e0a\u3067\u306f\u6700\u4f4e\u9650\u5fc5\u8981\u306a\u56e0\u5b50\u3067\u3042\u308b\u3068\u63a8\u5b9a\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u307e\u305f\uff0c\u816b\u760d\u306e\u5b58\u5728\u90e8\u4f4d\u304c\u751f\u547d\u4e88\u5f8c\u4e88\u6e2c\u56e0\u5b50\u3068\u3057\u3066\u306f\u6700\u3082\u5927\u304d\u3044\u3068\u3044\u3048\u307e\u3059\u3002\u4f8b\u3048\u3070\uff0c\u5927\u8133\u306b\u8868\u5728\u6027\u306b\u3042\u308bPNET\u306f\u624b\u8853\u3067 GTR (gross total removal)\u304c\u3067\u304d\u307e\u3059\u304c\uff0c\u5927\u8133\u57fa\u5e95\u6838\uff0c\u8996\u5e8a\uff0c\u8133\u5e79\u90e8\uff0c\u7b2c\uff13\u8133\u5ba4\u306a\u3069\u3092\u4fb5\u3059PNET\u306b\u304a\u3044\u3066\u306f\u305d\u308c\u304c\u3067\u304d\u306a\u3044\u304b\u3089\u3067\u3059<\/li>\n<li>\u3053\u306e\u610f\u5473\u3067\u306f\u816b\u760d\u306e\u5b58\u5728\u90e8\u4f4d\u304c\uff0c\u6cbb\u7642\u6cd5\u9078\u629e\u306b\u5f71\u97ff\u3092\u4e0e\u3048\u307e\u3059<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h4>\u6587\u732e<\/h4>\n<ol>\n<li>Burnett ME, et al.: Chromosome arm 17p deletion analysis reveals molecular genetic heterogeneity in supratentorial and infratentorial primitive neuroectodermal tumors of the central nervous system. Cancer Genet Cytogenet 97: 25-31. 1997<\/li>\n<li>Cefalo G, et al: Temozolomide is an active agent in children with recurrent medulloblastoma\/primitive neuroectodermal tumor: an Italian multi-institutional phase II trial. Neuro Oncol 16: 748-53, 2014<\/li>\n<li>Cohen BH, et al.: Prognostic factors and treatment results for supratentorial primitive neuroectodermal tumors in children using radiation and chemotherapy: a Children&#8217;s Cancer Group randomized trial. J Clin Oncol 13: 1687-1696, 1995<\/li>\n<li>Friedrich C, et al.: Treatment of young children with CNS-primitive neuroectodermal tumors\/pineoblastomas in the prospective multicenter trial HIT 2000 using different chemotherapy regimens and radiotherapy. Neuro Oncol 15: 224-234, 2013<\/li>\n<li>Gaffney CC, et al.: Primitive neuroectodermal tumours of the cerebrum. Pathology and treatment. J Neurooncol 3: 23-33, 1985<\/li>\n<li>Hong TS, et al.: Patterns of failure in supratentorial primitive neuroectodermal tumors treated in Children&#8217;s Cancer Group Study 921, a phase III combined modality study. Int J Radiat Oncol Biol Phys. 60: 204-213, 2004<\/li>\n<li>Raghuram CP, et al. : Is there a role for high dose chemotherapy with hematopoietic stem cell rescue in patients with relapsed supratentorial PNET? J Neurooncol. 2011 Aug 18. [Epub]<\/li>\n<li>Reddy AT, Janss AJ, Phillips PC, et al.: Outcome for children with supratentorial primitive neuroectodermal tumors treated with surgery, radiation, and chemotherapy. Cancer 88: 2189-2193. 2000<\/li>\n<li>Strother D, et al: Feasibility of four consecutive high-dose chemotherapy cycles with stem-cell rescue for patients with newly diagnosed medulloblastoma or supratentorial primitive neuroectodermal tumor after craniospinal radiotherapy: Results of a collaborative study. J Clin Oncol 19: 2696-2704, 2001<\/li>\n<li>Sturm D, et al.: New Brain Tumor Entities Emerge from Molecular Classification of CNS-PNETs. Cell 164:1060-1072, 2016<\/li>\n<li>Timmermann B, et al.: Role of radiotherapy in the treatment of supratentorial primitive neuroectodermal tumors in childhood: results of the prospective German brain tumor trials HIT 88\/89 and 91. J Clin Oncol 20: 842\u2013849, 2002<\/li>\n<li>Chintagumpala M, et al.: A pilot study of risk-adapted radiotherapy and chemotherapy in patients with supratentorial PNET. Neuro-Oncol 11: 33-44, 2009<\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed?term=%22Le%20Deley%20MC%22%5BAuthor%5D\">Le Deley MC<\/a> et al.: Impact of EWS-ETS fusion type on disease progression in Ewing&#8217;s sarcoma\/peripheral primitive neuroectodermal tumor: prospective results from the cooperative Euro-E.W.I.N.G. 99 trial. J Clin Oncol 28:1982-1988, 2010<\/li>\n<li><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed?term=%22van%20Doorninck%20JA%22%5BAuthor%5D\">van Doorninck JA<\/a>, et al.: Current treatment protocols have eliminated the prognostic advantage of type 1 fusions in Ewing sarcoma: a report from the Children&#8217;s Oncology Group. J Clin Oncol 28:1989-1994, 2010<\/li>\n<\/ol>\n<h3>\u6fa4\u6751\u81ea\u8eab\u306e\u7d4c\u9a13<\/h3>\n<p>\u79c1\u81ea\u8eab\u306f\uff0c1992\u5e74\u304b\u3089PNET\u306b\u5bfe\u3057\u3066\u7a4d\u6975\u7684\u5168\u6458\u51fa\u8853\uff0c\u8853\u5f8c\u306e\u8133\u810a\u9ac4\u7167\u5c04\u306b\u52a0\u3048\u3066\u30a4\u30d5\u30a9\u30b9\u30d5\u30a1\u30de\u30a4\u30c9\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9\u3092\u7528\u3044\u308bICE\u5316\u5b66\u7642\u6cd5\u3092\u3057\u3066\u3044\u307e\u3057\u305f\u3002\u79c1\u304c\u9ac4\u82bd\u816b\u306b\u884c\u3063\u3066\u3044\u305f\u6cbb\u7642\u65b9\u91dd\u3068\u540c\u3058\u3067\u3059\u30023\u6b73\u306b\u306a\u308b\u307e\u3067\u306f\u8133\u810a\u9ac4\u7167\u5c04\u3092\u884c\u308f\u305a\u306b\u5316\u5b66\u7642\u6cd5\u3092\u5148\u884c\u3055\u305b\u3066\uff0c\uff13\u624d\u4ee5\u4e0a\u306e\u60a3\u5150\u306b\u306f\u5316\u5b66\u7642\u6cd5\u3092\uff11\u30b3\u30fc\u30b9\u884c\u3063\u305f\u5f8c\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u307e\u3059\u3002\u3053\u306e\u5316\u5b66\u7642\u6cd5\u306f\u8853\u5f8c\uff12\u5e74\u9593\u306e\u9593\u306b\uff16\u301c\uff18\u30b3\u30fc\u30b9\u7d99\u7d9a\u3057\u307e\u3059\u3002\u816b\u760d\u5c40\u6240\u306b\u306f54\u30b0\u30ec\u30a4\u306e\u7dda\u91cf\u3092\u7528\u3044\u3066\uff0c\u8133\u810a\u9ac4\u7167\u5c04\u306f3-5\u6b73\u3067\u306f18\u30b0\u30ec\u30a4\uff0c\u305d\u308c\u4ee5\u4e0a\u3067\u306f24-25\u30b0\u30ec\u30a4\u3092\u4f7f\u3044\u307e\u3057\u305f\u3002\u3067\u30821990\u5e74\u4ee3\u306e\u4e2d\u9803\u307e\u3067\u306f2.5\u6b73\u306b\u306a\u308c\u3070\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u3066\u3044\u307e\u3057\u305f\u3002 2007\u5e74\u307e\u3067\u306b\u3053\u306e\u6cbb\u7642\u65b9\u91dd\u306715\u624d\u672a\u6e80\u306ePNET\u309212\u75c7\u4f8b\u6cbb\u7642\u3057\u307e\u3057\u305f\u304c\uff0c2011\u5e746\u6708\u6642\u70b9\u30678\u4f8b\u304c\u816b\u760d\u518d\u767a\u304c\u306a\u304f\u3066\u751f\u5b58\u3057\u3066\u3044\u307e\u3057\u305f\u3002\u3053\u306e\u6cbb\u7642\u6cd5\u306f\u78ba\u7acb\u3055\u308c\u305f\u3082\u306e\u3067\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u304c\uff0c1991\u5e74\u307e\u3067\u306b\u5317\u6d77\u9053\u5927\u5b66\u3067\u624b\u8853\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u6cbb\u7642\u3057\u305f\uff18\u75c7\u4f8b\u3067\u9577\u671f\u751f\u5b58\u4f8b\u304c\u5168\u304f\u306a\u3044\u3053\u3068\u3068\u6bd4\u8f03\u3059\u308c\u3070\u826f\u597d\u306a\u6210\u7e3e\u3068\u3082\u601d\u308f\u308c\u307e\u3059\u3002\u305f\u3060\u3057\uff0c\u79c1\u306e\u7d4c\u9a13\u3057\u305f12\u4f8b\u4e2d\u306e9\u4f8b\u3067\u624b\u8853\u5168\u6458\u51fa\u304c\u53ef\u80fd\u3067\u3042\u3063\u305f\u306e\u3067\uff0c\u3053\u306e\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u306e\u6210\u7e3e\u3092\u5358\u7d14\u306b\u826f\u3044\u3068\u306f\u8a55\u4fa1\u3067\u304d\u307e\u305b\u3093\u3002\u306a\u305c\u306a\u3089\u64ad\u7a2e\u304c\u306a\u304f\u3066\u624b\u8853\u3067\u5b8c\u5168\u6458\u51fa\u3067\u304d\u308bPNET\u306e\u4e88\u5f8c\u306f\u4ed6\u306e\u3082\u306e\u3088\u308a\u826f\u3044\u304b\u3089\u3067\u3059\u3002\u4eca\u5f8c\u306b\u4ed6\u306e\u65bd\u8a2d\u3067\u3082\u691c\u8a3c\u3055\u308c\u306a\u3051\u308c\u3070\u3053\u306e\u6cbb\u7642\u306f\u6b63\u3057\u3044\u304b\u3069\u3046\u304b\u306f\u5224\u308a\u307e\u305b\u3093\u3002<\/p>\n<p>\u305d\u308c\u306b\u3082\u3046\u4e00\u3064\u5927\u304d\u306a\u554f\u984c\u304c\u6b8b\u3055\u308c\u3066\u3044\u307e\u3059\u3002<span style=\"color: #000080;\"><strong>\u5927\u8133\u306b\u767a\u751f\u3059\u308bPNET\u306b\u306f\u5927\u8133\u306b\u5927\u91cf\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u5fc5\u8981<\/strong><\/span>\u306a\u306e\u3067\u3059\u3002\u3067\u3059\u304b\u3089\uff0c\uff13\u6b73\u306b\u306a\u3063\u305f\u3068\u3044\u3063\u3066\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u5b89\u6613\u306b\u3067\u304d\u308b\u8a33\u3067\u306f\u306a\u304f\u3066\uff0c\u6cbb\u7642\u5f8c\u306e\u8a8d\u77e5\u969c\u5bb3\uff08\u77e5\u80fd\u6307\u6570\u306e\u4f4e\u4e0b\uff09\u306e\u9032\u884c\u3059\u308b\u53ef\u80fd\u6027\u306f\uff0c\u9ac4\u82bd\u816b\u306e\u60a3\u5150\u3088\u308a\u3055\u3089\u306b\u5927\u304d\u3044\u306e\u3067\u3059\u3002\u3060\u304b\u3089\u3068\u3044\u3063\u3066\uff0c\u5316\u5b66\u7642\u6cd5\u3060\u3051\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u3067\u60a3\u5150\u304c\u751f\u304d\u6b8b\u308c\u308b\u3068\u3044\u3046\u4fdd\u8a3c\u306f\u3069\u3053\u306b\u3082\u3042\u308a\u307e\u305b\u3093\u3002\u4e21\u89aa\u3068\u306e\u9577\u304f\u6df1\u3044\u8a71\u3057\u5408\u3044\u306b\u306a\u308a\u307e\u3059\u304c\uff0c\u7d50\u8ad6\u306f\u51fa\u307e\u305b\u3093\u3002\u305d\u308c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u969c\u5bb3\u306f\u5e74\u9f62\u3060\u3051\u3067\u306f\u306a\u304f\u3066\uff0cPNET\u306e\u767a\u751f\u3057\u305f\u5927\u8133\u306e\u5834\u6240\u306b\u3088\u3063\u3066\u3082\u9055\u3046\u3068\u3044\u3046\u3053\u3068\u3092\u8a8d\u8b58\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u524d\u306b\u66f8\u3044\u305f\u524d\u982d\u8449\u3068\u9055\u3063\u3066\uff0c\u7247\u5074\u5f8c\u982d\u8449\u3067\u3042\u308c\u3070\u304b\u306a\u308a\u306e\u5c40\u6240\u7dda\u91cf\u3067\u3082\u8a8d\u77e5\u6a5f\u80fd\u306f\u3055\u307b\u3069\u843d\u3061\u307e\u305b\u3093\u3002\u3053\u306ePNET\u306e\u6cbb\u7642\u6cd5\u9078\u629e\u306e\u305f\u3081\u306e\u89b3\u70b9\u306f\uff0c\u9ac4\u82bd\u816b\u3068\u306f\u304b\u306a\u308a\u7570\u306a\u308a\u307e\u3059\u3002 \u5316\u5b66\u7642\u6cd5\u304c\u52b9\u304b\u306a\u3044\u3053\u3068\u3067\u77e5\u3089\u308c\u3066\u3044\u308b\u4e0a\u8863\u816b\u30fb\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u3068\u540c\u69d8\u306e\u8003\u3048\u65b9\u3092\u3068\u308c\u3070\uff0c\u816b\u760d\u5c40\u6240\u306b\u3060\u3051\u9ad8\u7dda\u91cf\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u3066\uff0c\u8133\u810a\u9ac4\u7167\u5c04\u3092\u3057\u306a\u3044\u3068\u3044\u3046\u9078\u629e\u80a2\u3082\u3042\u308b\u306e\u3067\u3057\u3087\u3046\u3002\u3067\u3082\u6c17\u3092\u3064\u3051\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u3053\u3068\u306f\uff0c\u4e0a\u8863\u816b\u3088\u308aPNET\u306f\u64ad\u7a2e\uff08\u8ee2\u79fb\uff09\u3057\u3084\u3059\u3044\u3053\u3068\uff0c\u4e0a\u8863\u816b\u3088\u308aPNET\u306e\u65b9\u304c\u5c40\u6240\u6d78\u6f64\u80fd\u304c\u9ad8\u3044\u3053\u3068\u3067\u3059\u3002\u3067\u3059\u304b\u3089\u5358\u7d14\u306b\u306f\u4e21\u8005\u3092\u540c\u4e00\u306b\u306f\u8ad6\u3058\u3089\u308c\u307e\u305b\u3093\u3002\u3067\u3082\u306a\u304a\uff0c\u5e83\u7bc4\u56f2\u306a\u5927\u8133\u7167\u5c04\u3092\u907f\u3051\u308b\u305f\u3081\u306b<span style=\"color: #000080;\"><strong>\u9650\u5c40\u7684\u306a\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u6b62\u3081\u308b\u3068\u3044\u3046\u9078\u629e\u80a2\u306f\u6b8b\u308a\u307e\u3059<\/strong><\/span>\u3002<\/p>\n<p>\u79c1\u3082\uff13\u6b73\u672a\u6e80\u3067\u624b\u8853\u3067\u5b8c\u5168\u6458\u51fa\u3067\u304d\u306a\u3044\u5834\u5408\u3068\u64ad\u7a2e\u304c\u3042\u308b\u75c7\u4f8b\u3067\u306f\uff0c\u901a\u5e38\u306e\u5316\u5b66\u7642\u6cd5\u306e\u5f8c\u3067\u5e79\u7d30\u80de\u79fb\u690d\u3068\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3046\u3079\u304d\u3067\u3042\u308d\u3046\u3068\u8003\u3048\u3066\u3044\u307e\u3059\u3002\u305f\u3060\u3057\u6761\u4ef6\u304c\u3042\u308a\u307e\u3059\u3002\u901a\u5e38\u5316\u5b66\u7642\u6cd5\u306b\u53cd\u5fdc\u3059\u308bPNET\u3067\u306f\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u4fa1\u5024\u3082\u3042\u308b\u306e\u3067\u3057\u3087\u3046\u304c\uff0c\u901a\u5e38\u5316\u5b66\u7642\u6cd5\u306b\u53cd\u5fdc\u3057\u306a\u3044PNET\u306b\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u3057\u3066\u3082\uff0c\u305d\u306e\u52b9\u679c\u306f\u671f\u5f85\u3067\u304d\u306a\u3044\u3068\u8003\u3048\u3089\u308c\u307e\u3059\u3002\u307e\u305f\u5168\u6458\u51fa(gross total removal)\u3067\u304d\u3066\u3044\u3066\u3082\u4e21\u5074\u306e\u524d\u982d\u8449\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u4f8b\u3067\u306f\uff0c\u77e5\u80fd\u306e\u969c\u5bb3\u304c\u9ad8\u5ea6\u306b\u306a\u308b\u3053\u3068\u306f\u76ee\u306b\u307f\u3048\u3066\u3044\u307e\u3059\u306e\u3067\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u9078\u629e\u4f59\u5730\u306f\u3042\u308b\u306e\u3067\u3057\u3087\u3046\u3002\u3057\u304b\u3057PNET\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u3092\u5927\u91cf\u306b\u3057\u305f\u304b\u3089\u3068\u3044\u3063\u3066\u7c21\u5358\u306b\u6cbb\u7652\u7387\u304c\u4e0a\u304c\u308b\u3088\u3046\u306a\u751f\u6613\u3057\u3044\u816b\u760d\u3067\u306f\u306a\u3044\u306e\u3067\uff0c\u4eca\u5f8c\u3082\u51b7\u9759\u306b\u4e16\u754c\u304b\u3089\u5831\u544a\u3055\u308c\u308b\u9577\u671f\u6210\u7e3e\u3092\u898b\u3066\u3044\u304b\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u304c\u3067\u304d\u308b\u3068\u3044\u3046\u3053\u3068(feasibility)\u3068\u305d\u306e\u5316\u5b66\u7642\u6cd5\u3067\u78ba\u304b\u306b\u9577\u671f\u751f\u5b58\u5272\u5408 (survival rate)\u304c\u4e0a\u304c\u308b\u3068\u3044\u3046\u3053\u3068\u306f\u5168\u304f\u9055\u3063\u305f\u3053\u3068\u306a\u306e\u3067\u3059\u3002<\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlalone.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-7743\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlalone-550x364.jpg\" alt=\"owlalone\" width=\"550\" height=\"364\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlalone-550x364.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlalone-300x199.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlalone.jpg 1000w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u5c0f\u5150\u306e\u8133\u306b\u767a\u751f\u3059\u308b\u60aa\u6027\u8133\u816b\u760d\u306e\u7dcf\u79f0\u3067\u3059 \u3059\u3079\u3066WHO \u30b0\u30ec\u30fc\u30c9\uff14\u3067\u3059 \u4f8b\u5916\u3082\u3042\u308a\uff0cCRINET\u306f\u826f\u6027\u816b\u760d\u306e\u3088\u3046\u306a\u3082\u306e\u3067\u3059 \u9ac4\u82bd\u816b medulloblastoma \u3068\u00a0AT\/RT \u304c\u4ee3\u8868\u683c\u3067\u3059 \u4ed6\u306e\u3082\u306e\u306f\u7121\u8996\u3057\u3066\u3044\u3044\u304f\u3089\u3044 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-195","post","type-post","status-publish","format-standard","hentry","category-pediattumor"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/195","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/comments?post=195"}],"version-history":[{"count":120,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/195\/revisions"}],"predecessor-version":[{"id":22164,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/195\/revisions\/22164"}],"wp:attachment":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/media?parent=195"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/categories?post=195"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/tags?post=195"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}